使用深动脉穿孔器皮瓣进行乳房再造时,采用一条静脉吻合还是两条静脉吻合--是否有区别

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-04-27 DOI:10.1002/micr.31179
Charalampos Varnava M.D, Maximilian Kueckelhaus M.D MBA, Sascha Wellenbrock M.D, Tobias Hirsch M.D, Philipp Wiebringhaus M.D., MHBA
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引用次数: 0

摘要

背景深动脉穿孔器(PAP)瓣作为乳房重建中的一种可靠替代方法,已受到广泛欢迎。大量研究集中于其血管供应、解剖技术以及乳房重建以外的更广泛应用。本研究旨在探讨 PAP 皮瓣吻合的静脉数量与术后并发症之间的相关性。 方法 对我院 2018 年至 2022 年期间使用 PAP 皮瓣进行乳房重建的结果进行回顾性研究。共纳入了 88 名患者的 103 个 PAP 皮瓣。通过统计分析,比较了单静脉吻合皮瓣和双静脉吻合皮瓣的疗效。对患者特征、术中和术后参数进行了分析。 结果 36 个皮瓣(35.0%)采用了一条静脉吻合,而 67 个皮瓣(65.0%)采用了两条静脉吻合。单静脉组和双静脉组的患者特征无明显差异。单静脉与双静脉皮瓣缺血时间的比较结果显示,两者的差异无统计学意义,平均缺血时间分别为(56.2±36.8)分钟和(58.7±33.0)分钟。在结果方面,两组之间在二次脂肪填充、静脉吻合术翻修或皮瓣总损失方面没有统计学意义上的显著差异。在 5 个(13.9%)单静脉皮瓣和 5 个(7.5%)双静脉皮瓣中观察到脂肪坏死,这表明两组之间的差异无统计学意义(P = .313)。在单静脉组中,最常用的耦合环直径为 2.5 毫米。在双静脉组中,最常用的组合是直径 2.0 毫米和直径 2.5 毫米的组合。 结论 根据我们的研究结果,单静脉吻合和双静脉吻合都是使用 PAP 皮瓣进行乳房重建的可行方案。使用一根或两根静脉对缺血时间或皮瓣损失没有明显影响。单静脉组的脂肪坏死发生率较高,但这一差异也没有统计学意义。这些发现强调了两种方法的有效性,为外科医生提供了根据患者的具体情况和解剖因素灵活调整手术技术的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
One versus two vein anastomoses in breast reconstruction with a profunda artery perforator flap—does it make a difference

Background

The profunda artery perforator (PAP) flap has gained popularity as a reliable alternative in breast reconstruction. Extensive research has focused on its vascular supply, dissection techniques, and broader applications beyond breast reconstruction. This study aims to investigate the correlation between the number of veins anastomosed for the PAP flap and postoperative complications.

Methods

A retrospective study was conducted to evaluate the outcomes of breast reconstructions with PAP flaps at our institution between 2018 and 2022. A total of 103 PAP flaps in 88 patients were included. Statistical analysis was performed to compare outcomes between flaps with one vein anastomosis and those with two vein anastomoses. Patient characteristics, intra and postoperative parameters were analysed.

Results

One vein anastomosis was used in 36 flaps (35.0%), whereas two vein anastomoses were used in 67 flaps (65.0%). No significant differences were found in patient characteristics between the one vein and two vein groups. The comparison of ischemia times between flaps with one versus two veins revealed no statistically significant difference, with mean ischemia times of 56.2 ± 36.8 min and 58.7 ± 33.0 min, respectively. Regarding outcomes, there were no statistically significant differences in secondary lipofilling, revision of vein anastomosis, or total flap loss between the two groups. Fat necrosis was observed in 5 (13.9%) one vein flaps and 5 (7.5%) two vein flaps, indicating no statistically significant difference between the two groups (p = .313). In the one vein group, the most frequently employed coupler ring had a diameter of 2.5 mm. In the two vein group, the most prevalent combination consisted of a 2.0 mm diameter with a 2.5 mm diameter.

Conclusion

Based on our study results, both one vein anastomosis and two vein anastomoses are viable options for breast reconstruction with PAP flap. The utilization of either one or two veins did not significantly affect ischemia time or flap loss. Fat necrosis exhibited a higher incidence in the single-vein group; however, this difference was also not statistically significant. These findings underscore the effectiveness of both approaches, providing surgeons with flexibility in tailoring their surgical techniques based on patient-specific considerations and anatomical factors.

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来源期刊
Microsurgery
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.
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