ZOR DURUMLARDA ALICI DAMAR OLARAK SERBEST FLEP KİMERİZASYONUNU İÇEREN FARKLI MODALİTELERLE BİRLİKTE TORAKOAKROMİAL ARTERYEL GÖVDE VE SEFALİK VEN SİSTEMİNİN KULLANIMI

Year 2021, Volume: 28 Issue: 2, 247 - 253, 15.06.2021

Selman Hakkı Altuntaş Fuat Uslusoy Dudu Dilek Yavuz Asım Aydın

https://doi.org/10.17343/sdutfd.747028

Abstract

Amaç
Baş-boyun, kol ve gövdeye konforlu ve güvenilir olarak
serbest flep transferi için, bu bölgelerin ana alıcı
damarlarının önceki cerrahi, radyoterapi veya travma
sonucu elverişsiz olmaları durumunda, cerrahlara Torakoakromial
arter gövdesi ve Sefalik venin (TAT-CV)
varlığını hatırlatmayı amaçladık.
Gereç ve Yöntem
Baş-boyun veya üst ekstremitede tümör veya travmayı
içeren, bu vasküler sistemin farklı modalitelerle
kullanılarak serbest doku transferi ile tedavi edilen 8
hasta retrospektif olarak incelendi.
Bulgular
Bu vasküler sistem bütün vakalarda güvenilir olduğunu
kanıtladı. Pektoral flep ile kimerizasyonu mümkün
kıldı. Baş-boyun rekonstrüksiyonu için 6 hastada ve
2 üst ekstremite restorasyonunda kullanıldı. Anastomozların
TAT-CV bölgesine taşınması ve CV transpozisyonu,
dolaşım sorunu olan flebi kurtarmak için oldukça
hızlı ve güvenilir yöntemler olarak bulundu.
Sonuç
Birçok rekonstrüktif cerrah tarafından anatomik olarak
iyi bilinmesine rağmen, diseksiyonunun kolaylığı,
tutarlılığı, farklı çaplı dallarının sağladığı kanlanma
ve stratejik lokasyonu yeterince rağbet görmemektedir.
Ayrıca pektoralis majör flep transferi sırasında ek
doku gereksinimi olduğunda, bu vasküler sistem alıcı
olarak orada hazır bulunmaktadır.

Keywords

Sefalik ven, Serbest flep, Torakoakromial arter

THE USE OF THORACOACROMIAL ARTERIAL TRUNK AND CEPHALIC VEIN SYSTEM WITH DIFFERENT MODALITIES INCLUDING CHIMERIZATION OF FREE FLAP IN DIFFICULT SITUATIONS AS THE RECIPIENT VESSELS

Abstract

Objective
We aimed to remind surgeons of the presence of the
thoracoacromial arterial trunk and cephalic vein (TATCV)
for a comfortable and reliable free flap transfer
to the head, arm, and trunk, in case the mainstream recipient vessels of these regions pose some inconveniences
due to previous surgery, radiotherapy, or
trauma.
Material and Methods
Eight cases of trauma or tumor involving the head and
neck or upper extremity, treated with free tissue transfer
in which this vascular system was used with different
modalities, were reviewed retrospectively.
Results
This vascular system proved to be reliable in all cases.
It enabled chimerization with the pectoral flap. It was
used in six patients for head and neck reconstructions
and in two upper extremity restrorations. Switching
the anastomoses to TAT-CV site and cephalic vein
transposition were found to be rapid and reliable methods
to rescue a flap with compromised circulation.
Discussion
Although anatomically well known by many reconstructive
surgeons, its ease of dissection, consistency,
supply of branches of differing caliber, and strategic
location is not adequately appreciated. Moreover, in
cases of pectoralis major flap transfer in which additional
tissue is required, this vascular system is already
there to receive it.

Keywords

Cephalic vein, Free flap, Thoracoacromial artery

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