ABSTRACT
Objective:To explore the clinical application of lateral thoracic artery perforator flap in repairing local defect after breast conserving surgery.Methods:The clinical data of 48 breast cancer patients planned to finish breast conserving surgery were retrospectively analyzed. The patients were divided into plastic breast-conserving group and routine breast conserving group. In the plastic breast-conserving group, 24 patients local defect repaired with the lateral thoracic artery perforator flap. In the routine breast conserving group, 24 patients local defect repaired with the fascial flap around the cutting edge. The operation related indexes and cosmetic effect from two groups were compared.Results:Both groups of patients successfully completed breast conserving surgery. The plastic breast-conserving group patients had significantly increased in operation time, operative blood loss, incision length and drainage tube indwelling time compared with the routine breast conserving group; the differences were statistically significant ( t=6.99, 9.37, 21.74, 8.80, P<0.05). The rate of secondary surgery enlarged was lower than fhat in the routine breast conserving group, and the difference was statistically significant (χ 2=4.76, P<0.05). There were 3 cases in the plastic breast conserving group and 1 case in the conventional breast conserving group. The skin at the edge of the flap was ischemic necrosis in the 4 cases, which healed after dressing change and drainage, and there was no significant difference ( P>0.05). The evaluation of postoperative cosmetic effect showed that the excellent and good rate of the observation group was 91.7%, compared with the routine breast conserving group (58.3%); the difference was statistically significant (χ 2=7.11, P<0.05). All patients were followed up for average 24 months, and local recurrence and distant metastasis were not observed. Conclusions:The lateral thoracic artery perforator flap for filling local defects in the lateral quadrant or central region of breast cancer is feasible, easy to operate, hides incision scar, better cosmetic effect and worthy of clinical promotion.
ABSTRACT
Introduction: Variation in the branching pattern of axillary artery is quite common. Accurate knowledge of thenormal and variant arterial anatomy of the axillary artery is important for clinical procedures in axillary andpectoral region. The aim of this study is to find out the incidence and types of variation in the branching patternof axillary artery.Materials and Methods: Dissection of axillary and pectoral region was done on both sides in 25 cadavers in thedepartment of Anatomy, K.P.C. Medical College and Hospital, Kolkata to study the branching pattern of axillaryartery.Results: Variation was present in 16% cases. Among these, 6% variation was present in the second part and 10%variation was present in the third part of axillary artery. Most common variation found was the origin ofsubscapular artery from the second part of axillary artery.Conclusion: Proper knowledge of variations of branching pattern of axillary artery is important for orthopaedic,reconstructive and vascular surgeons to avoid complications during various surgical procedures in axillaryregions and angiographies.
ABSTRACT
Introduction: Lateral thoracic artery is one of the branches of second part of axillary artery which arises near thelateral border of pectoralis minor.Aim and Objectives: To study the variations in the origin of Lateral thoracic artery and note its pattern.Materials and methods: 54 axillae from embalmed cadavers allotted for dissection were used for the study.There were 22 male and 5 female cadavers, with ages ranging from 60 to 80 years, specimens of both sides wereused.Results: The commonest variation was common trunk for Lateral thoracic artery and Thoracodorsal Artery(9.5%).Conclusion: The study was carried out to show important variations in the branching pattern of lateral thoracicartery, in order to orient the surgeons performing reconstructive plastic surgery and modified radial mastectomy.
ABSTRACT
Comparing with free perforator flap, pedicled flap is a relatively simpler and safer technique, with lesser donor site morbidity. In recent years, the application of pedicled perforator flaps has emerged as a new option for breast reconstruction. Those pedicled perforator flaps include thoracodorsal artery perforator flap, intercostal artery perforator flap (lateral intercostal artery perforator flap, anterior intercostal perforator flap) etc. Serratus anterior artery perforator flap, superior epigastric artery perforator flap, and lateral thoracic artery perforator flap can also be raised technically. To enhance surgical accuracy, it is necessary to evaluate the location and quality of perforator vessels preoperatively. Proper flap design is of more importance for pedicled flap when compared with it's free flap counterpart. Although free flap approach remains the golden standard in breast reconstruction when considering autologous tissue transplantation, pedicled perforator flap has the apparent merits of minimized surgical trauma, less time-consuming and less stress for reconstructive surgeons.
ABSTRACT
An unusual anomalous branching pattern of axillary artery was observed in the middle aged male cadaver during routine cadaveric dissection. The lateral thoracic artery was found to emerge from third part of axillary artery forming a common trunk with subscapular artery and posterior circumflex humeral on left side. It was also noted that, the long thoracic nerve was passing between the two branches of lateral thoracic artery. Such course of long thoracic nerve makes it highly vulnerable to compression and injury, which may manifest as winging scapula. Sound knowledge of such neurovascular variations is important for surgeons, anesthesiologists and orthopedic surgeons, which may prevent diagnostic errors.