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題名 | Using a Y-Shaped Vein Graft with Drain-out Branches to Provide Additional Arterial Sources for Free Flap Reconstruction in Injured Lower Extremities=利用分流式Y型脈移植提供游離皮瓣之動脈血流以完成困難的下肢重建 |
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作者 | 曹中侃; 陳宏基; 陳煥棠; | 書刊名 | 長庚醫學 |
卷期 | 26:11 2003.11[民92.11] |
頁次 | 頁813-821 |
分類號 | 416.413 |
關鍵詞 | Y型靜脈移植; 游離皮瓣; 血流重建; 肢體重建; Y-shpaed vein graft; Free flaps; Revascularization; Limb preservation; |
語文 | 英文(English) |
中文摘要 | 背景:要重建血液循環不良的達端肢體對外科醫師而言,是一項困難的挑戰;尤其是需要做顯微游離組織移植時。我們會遭遇到的一種情形是,除了一條供應遠端循環的主要動脈之外,沒有其合適的接受區動脈可資運用。為了克服這種困難,而在不影響達端的血液循環之下完成游離皮瓣之移植,我們嘗試運用Y形靜脈移植來解決問題。 方法:我們報告了三位使用Y形靜脈移植而成功的達成下肢重建的病例。Y形靜脈移植提供游離皮瓣動脈血流的同時,也保留了下肢遠端的循環。文中詳細論述了治療目的、手術方式、設計以及結果。並且針對適應症以及優缺點加以討論。 結果:三位病例均成功的達成下肢重建的目的。運用Y形靜脈移植並不需要特殊的顯微手術技巧。所提供的接受區動脈是既可靠又實用,可符合各種顯微移植組織的重建需要。由於只有分流型的靜脈分?才能達到將動脈分流的目的,所以在取下Y形靜脈移植前,必要仔細確認血流的方向。 結論:我們的結論是在一些血管問題特殊的情形下,要達成以自由游離皮瓣重建遠端下肢的目的,使用Y形靜脈移植是一個很好的解決方法。 |
英文摘要 | Baclground: Reconstruction of the distal lower extremity with poor arterial circulation is a challenge for reconstructive surgeons, especially when a microsurgical free tissue transfer is necessary. One may face the problem of having no suitable recipient artery to be used except the main one. To overcome this difficult situation, utilization of a Y-shaped vein graft (YVG) was developed. Methods: We report on 3 successful reconstructions of the lower extremities with free flaps using YVG to supply the arterial inflow and in which the distal circulation of the lower extremity was preserved at the same time. The therapeutic goals, design, surgical technique, and outcomes are clarified. The indications, advantages, and disadvantages are also discussed. Results: All 3 patients achieved successful reconstruction of the affected limbs with uneventful surgery. Special microsurgical skills are unnecessary in this method. It can provide an additional arterial source, which is useful and reliable for revascularizing various kinds of free tissue. Utmost car must be taken to examine the direction of low during harvesting since only the drainout branches can serve as an ideal YVG. Conclusion: We concluded that Y-shaped vein grafting is a good alternative technique to achieve free flap reconstruction of a distal lower extremity with simulataneous preservation of the distal circulation in selected difficult cases. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。