用于肿瘤胸壁重建的游离大腿前外侧阔筋膜瓣和连体大腿前外侧阔筋膜瓣/张肌筋膜瓣。

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-07-24 DOI:10.1002/micr.31212
Florian Falkner MD, Benjamin Thomas MD, MSc, Simon A. Mayer MD, Oliver Didzun MD, Leonard Knoedler MD, Adriana C. Panayi MD, Gabriel Hundeshagen MD, Felix H. Vollbach MD, Emre Gazyakan MD, Ulrich Kneser MD, Amir K. Bigdeli MD
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引用次数: 0

摘要

简介:游离肌皮阔筋膜(VL)皮瓣是广泛胸壁重建的一种选择,它可以单独使用,也可以与大腿前外侧筋膜(cVLALT)和/或肌筋膜张力筋膜(cVLTFL)皮瓣一起使用。我们旨在直接比较这些重建方案的效果:这项回顾性研究纳入了 2010 年 2 月至 2022 年期间使用游离 VL、cVLALT 或 cVLTFL 皮瓣进行肿瘤胸壁重建的患者。研究评估了患者的人口统计学特征、手术特征以及医疗和重建结果。比较了肌皮VL、cVLALT和cVLTFL皮瓣重建的手术效果:结果:共有 41 名患者接受了游离肌皮 VL(n = 25;61%)、cVLALT(n = 14;34%)或 cVLTFL 的胸壁重建术。整个队列中有 3 例急性皮瓣血栓形成(3/41,7%),其中 1 例肌皮 VL 皮瓣因在挽救手术中复发静脉血栓而失败。两例皮瓣完全坏死(5%;VL皮瓣:n = 1;cVLALT皮瓣:n = 1),一例VL皮瓣部分坏死(1/25,4%),三例cVLALT皮瓣远端ALT部分坏死(3/14,21%)。孤立VL皮瓣和连体VL皮瓣的部分坏死率(p = .28)或全部皮瓣坏死率(p = .9)无明显差异:结论:游离(连体)VL皮瓣能可靠地消除死腔,实现复杂胸壁缺损的持久重建。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The free vastus lateralis—And conjoined vastus lateralis anterolateral thigh/tensor fascia lata flap for oncological chest wall reconstruction

Introduction

A reconstructive option for extensive chest wall reconstruction is the free myocutaneous vastus lateralis muscle (VL) flap which can be performed in isolation or in conjunction with a fasciocutaneus anterolateral thigh (cVLALT) and/or myofasciocutaneous tensor fascia lata flap (cVLTFL). We aimed to directly compare the outcomes of these reconstructive options.

Methods

Patients who underwent oncological chest wall reconstruction with a free VL, cVLALT, or cVLTFL flap between February 2010 and 2022 were included in this retrospective study. Patient demographics, surgical characteristics, as well as medical and reconstructive outcomes, were evaluated. The operative outcomes between myocutaneous VL, cVLALT, and cVLTFL flap reconstructions were compared.

Results

A total of 41 patients underwent chest wall reconstruction with a free myocutaneous VL (n = 25; 61%), cVLALT (n = 14; 34%), or cVLTFL Three acute flap thromboses occurred in the entire cohort (3/41, 7%), with one myocutaneous VL flap failing because of recurrent venous thrombosis during the salvage procedure. Total flap necrosis was seen in two cases (5%; VL flap: n = 1; cVLALT flap: n = 1), and partial flap necrosis in one VL flap (1/25, 4%) and in the distal ALT portion of three cVLALT flaps (3/14, 21%). No significant difference was seen between isolated VL and conjoined VL flaps regarding the partial (p = .28) or total flap necrosis rate (p = .9).

Conclusion

The free (conjoined) VL flap provides reliable outcomes for obliterating dead space achieving durable reconstruction of complex chest wall defects.

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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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