The vascularized groin lymph node flap (VGLN)
| Autor: | Benoit Hendrickx, Assaf Zeltzer, Alexander Anzarut, Moustapha Hamdi, Eddy Van Hedent, Delphine Braeckmans, Katrin Seidenstuecker |
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| Přispěvatelé: | Faculty of Medicine and Pharmacy, Physiotherapy, Human Physiology and Anatomy, Anatomical Research and Clinical Studies, Plastic Surgery, Surgical clinical sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Anterior superior iliac spine
Breast Neoplasms Free flap 030230 surgery Surgical Flaps Cohort Studies 03 medical and health sciences 0302 clinical medicine Multidetector Computed Tomography medicine Humans lymphedema post mastectomy breast cancer Lymphedema Pubic tubercle Lymph node Mastectomy Medicine(all) Groin business.industry General Medicine Anatomy Middle Aged medicine.disease groin body regions lymph node flap medicine.anatomical_structure Lymphatic system Oncology 030220 oncology & carcinogenesis Tissue and Organ Harvesting Female Surgery Lymph Nodes Lymph business |
| Popis: | Introduction A growing number of surgeons perform lymph node transfers for the treatment of lymphedema. When harvesting a vascularized lymph node groin flap (VGLNF) one of the major concerns is the potential risk of iatrogenic lymphedema of the donor-site. This article helps understanding of the lymph node distribution of the groin in order to minimize this risk. Materials and methods Fifty consecutive patients undergoing abdominal mapping by multi-detector CT scanner were included and 100 groins analyzed. The groin was divided in three zones (of which zone II is the safe zone) and lymph nodes were counted and mapped with their distances to anatomic landmarks. Further node units were plotted and counted. Results The average age was 48 years. A mean number of nodes of 6.5/groin was found. In zone II, which is our zone of interest a mean of 3.1 nodes were counted with a mean size of 7.8 mm. In three patients no nodes were found in zone II. In five patients nodes were seen in zone II but were not sufficient in size or number to be considered a lymph node unit. On average the lymph node unit in zone II was found to be 48.3 mm from the pubic tubercle when projected on a line from the pubic tubercle to the anterior superior iliac spine, 16.0 mm caudal to this line, and 20.4 mm above the groin crease. On average the lymph node unit was a mean of 41.7 mm lateral to the SCIV-SIEV confluence. Conclusion This study provides increased understanding of the lymphatic anatomy in zone II of the groin flap and suggests a refined technique for designing the VGLNF. As with any flap there is a degree of individual patient variability. However, having information on the most common anatomy and flap design is of great value. |
| Databáze: | OpenAIRE |
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