Potential of the Thoracoepigastric Vein as a Drainage Vein in Breast Reconstruction With a Free Flap: An Anatomical Study Using Computed Tomography

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2024-09-13 DOI:10.1002/micr.31230

Hitoshi Nemoto, Kengo Nakatsuka, Daiki Morita, Yukio Seki, Kotaro Imagawa, Yotaro Tsunoda, Chieko Komaba, Ushio Hanai

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引用次数: 0

Abstract

Background

The recipient vessel choice is very important when performing free-flap breast reconstructions. Usually, the concomitant vein of the recipient artery is anastomosed, and mismatches in the diameter are occasionally observed. We consider the thoracoepigastric vein (TEV) as a potential useful recipient vein. The use of the TEV is not a novel technique. It has been used by surgeons for free-flap anastomoses in the axillary region, but usually as an anastomotic site for the second vein. However, anatomical findings such as TEV diameter, its deficiency rate, and influence on mastectomy are not clear. In this study, computed tomography (CT) was performed to evaluate the use of the TEV as a recipient vein for breast reconstruction.

Methods

The medical records of patients who underwent breast reconstruction with free-flap transfer were retrospectively evaluated. In most cases, CT was performed using a tissue expander inserted after mastectomy. The TEV was considered suitable if its diameter on the mastectomy side was >1 mm and the vertical distance from the most distal slice level where the TEV could be seen at the third costal cartilage height of the parasternal region was <50 mm.

Results

Sixty-six sides of 33 patients were evaluated. The mean age of the patients was 49.3 ± 5.1 years. The TEV was used in five flaps. TEV diameters were not significantly different between the left and right sides (1.85 ± 0.53 vs. 1.82 ± 0.6, respectively, p = 0.836). On the mastectomy side, eight (25%) TEVs were injured, but only three (8.6%) were considered unavailable. On the healthy side, 96.4% TEVs were available.

Conclusions

TEVs may be a good choice as vein anastomosis targets for breast reconstruction with a free flap because of their relatively large vessel diameter.

Trial Registration

UMIN-CTR: R000061573

查看原文本刊更多论文

游离皮瓣乳房再造术中胸腹静脉作为引流静脉的潜力：使用计算机断层扫描的解剖学研究

背景在进行游离瓣乳房重建时，受体血管的选择非常重要。通常情况下，受体动脉的伴行静脉会被吻合，偶尔也会出现直径不匹配的情况。我们认为胸腹静脉（TEV）是一种潜在的有用受体静脉。使用胸腹静脉并不是一项新技术。外科医生已将其用于腋窝区域的游离瓣吻合，但通常是作为第二静脉的吻合部位。然而，TEV 的直径、缺损率以及对乳房切除术的影响等解剖学发现尚不清楚。本研究通过计算机断层扫描（CT）来评估将 TEV 用作乳房重建受体静脉的情况。方法回顾性评估了接受游离瓣转移乳房重建术患者的病历。在大多数病例中，CT 是在乳房切除术后插入组织扩张器进行的。如果乳房切除侧的 TEV 直径为 1 毫米，且胸骨旁区域第三肋软骨高度处可看到 TEV 的最远切片水平的垂直距离为 50 毫米，则认为 TEV 合适。结果对 33 名患者的 66 个侧面进行了评估。患者的平均年龄为 49.3 ± 5.1 岁。五个皮瓣使用了 TEV。左侧和右侧的 TEV 直径无明显差异（分别为 1.85 ± 0.53 vs. 1.82 ± 0.6，p = 0.836）。在乳房切除侧，8 个 TEV（25%）受伤，但只有 3 个（8.6%）被认为不可用。在健康一侧，96.4%的 TEV 可用。结论 TEV 因其血管直径相对较大，可能是游离皮瓣乳房重建的静脉吻合目标的良好选择。试验注册 UMIN-CTR: R000061573

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.