乳房再建における移植床血管としての胸背動静脈前鋸筋枝の有用性

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  • Usefulness of Serratus Anterior Branch of Thoracodorsal Vessels as Recipient Vessels for Free DIEP Flap Transfer in Breast Reconstruction

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 Free DIEP flaps and supercharged TRAM flaps have been widely used in breast reconstruction in recent years. Internal mammary vessels and main trunks of thoracodorsal vessels are chiefly selected as recipient vessels for microvascular anastomoses. The serratus anterior branch of thoracodorsal vessels are rarely reported as recipient vessels in breast reconstruction.<br> Free DIEP flap and supercharged TRAM flap were transferred using the serratus anterior branch of thoracodorsal vessels as recipient vessels in patients. The age of the patients, irradiation history, the diameter of recipient vessels and flap vessels, and survival rate of flaps were studied.<br> Two free DIEP flaps and three supercharged TRAM flaps were transferred. Three of the five were primary reconstruction, and the others were secondary reconstruction. The average age of the patients was 47.3. The average diameter of the recipient artery and vein were 1.6 mm and 1.7mm respectively. All flaps survived completely.<br> The serratus anterior branches of thoracodorsal vessels have often been preserved in breast excision, even after axillary dissection. The main trunks of thoracodorsal vessels are preserved after using serratus anterior branch, and therefore, latissimus dorsi muscle can be elevated safely as a salvage surgery. These vessels are considered as one of the options for recipient vessels in supercharged TRAM flaps and free DIEP flaps.

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