利用浅静脉瓣进行淋巴管吻合治疗腹股沟复发性淋巴囊肿的带蒂SIEA皮瓣中的淋巴管:病例报告和文献综述。

IF 1.3 Q3 SURGERY
Archives of Plastic Surgery-APS Pub Date : 2024-06-13 eCollection Date: 2024-07-01 DOI:10.1055/s-0044-1782142
Federico Facchin, Elmar Fritsche, Alberto Franchi
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引用次数: 0

摘要

腹股沟淋巴结肿大是腹股沟手术的一种并发症,会严重影响患者的生活质量。许多学者认为,恢复中断的淋巴通路是防止复发的理想治疗方法。然而,多次抽吸手术和手术翻修可能会影响淋巴管旁路手术所需的局部静脉的可用性。此外,对长期存在的淋巴管进行手术清创会产生大量死腔和轮廓畸形。为经瓣淋巴孔吻合术(LVA)提供额外静脉的皮瓣可以通过提供软组织和在损伤区域外采集的合格静脉来克服这两个问题。本文介绍了一例利用腹部皮瓣经皮瓣淋巴孔吻合术治疗严重腹股沟淋巴结核的成功病例。患者因脂肪瘤切除术后右侧腹股沟淋巴结复发而转诊至我院,虽经多次手术尝试,但淋巴结仍持续存在。在确定腹股沟淋巴管通畅且有引流后,我们采用捏合试验设计了一个小型腹股沟浅表上皮下动脉皮瓣。颅骨切口的浅静脉被确定并与淋巴管吻合,然后将带蒂皮瓣收获并嵌入腹股沟。淋巴引流的早期恢复和最佳的美学效果支持了经皮瓣淋巴管瓣的联合方法,它是治疗严重和顽固性淋巴囊肿的重要选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
LVAs in a Pedicled SIEA Flap for the Treatment of Recurrent Lymphocele of the Groin Using Superficial Veins of the Flap for Lymphovenous Anastomosis: A Case Report and Literature Review.

Persistent lymphocele of the groin is a complication of groin surgery that can severely impact the quality of life. The restoration of the interrupted lymphatic pathway is considered by many authors the ideal treatment to prevent a recurrence. However, multiple aspiration procedures and surgical revisions can compromise the availability of local veins needed for a lymphovenular bypass surgery. In addition, surgical debridement of a long-standing lymphocele can generate extensive dead space and contour deformity. A flap delivering additional venules for trans-flap lymphovenular anastomoses (LVAs) can overcome both problems by providing soft tissue and competent veins harvested outside the zone of injury. A successful case of severe groin lymphocele treated with trans-flap LVAs from an abdominal-based flap is presented. The patient was referred to us for a recurrent lymphocele developed in the right groin after lipoma excision that persisted despite multiple surgical attempts. After the identification of patent and draining inguinal lymphatic vessels, a pinch test was used to design a mini-abdominoplasty superficial inferior epigastric artery flap. The superficial veins of the cranial incision were identified and anastomosed to the lymphatic vessels after the pedicled flap harvested and insetted in the groin. The early restoration of lymphatic drainage and the optimal aesthetic outcome supports the combined approach offered by trans-flap LVAs as a valuable therapeutic option for severe and persistent lymphocele.

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来源期刊
CiteScore
2.10
自引率
6.70%
发文量
131
审稿时长
10 weeks
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