遊離移植組織の臨床解剖学的研究 第２報 腹直筋皮弁の脈管系について

Abstract

Deep inferior epigastric (DIE) vessels, important to vascular apastomosis of an inferior rectus abdominis free flap, were studied clinicoanatomically. This study included morphologic and morphometric examinations of the DIE artery and vein. Bifurcations of the DIE vessels, venous valves, the inner diameters of the DIE vessels, and their lengths were recorded. The following results were obtained:1. Morphologic examination: 1) In the artery, single type (no bifurcation of the DIE artery observed) accounted for 72%. 2) In the vein, single type (no bifurcation of the DIE vein observed) accounted for 2%, distal type (two companion veins of the DIE vein come together to form one trunk before joining the external iliac vein) 33%, medial type (two companion veins of the DIE vein come together just at the point of joining the external iliac vein) 14%, and direct type (two companion veins of the DIE vein join the external iliac vein independently) 2%. 3) The DIE artery anastomosed with the superior epigastric artery in the upper abdomen. 4) Numerous surface branches of DIE arteries were evident in the paraumbilicas region. 5) Most venous valves were bicuspid. 6) Most venous valves were at the bifurcation in the distal type.2. Morphometric examination: 1) The mean inner diameter of the DIE artery 5 mm distal from the DIE artery junction was 1.9±0.5 mm. 2) The mean inner diameters of the DIE veins 5 mm distal from the external iliac veins were 1.7±1.1 mm in the medial type, 2.5±1.5 mm in the distal type, 2.1±1.1 mm in the direct type, and 2.6 mm in the single type. 3) The maximum mean length of artery that could be used as a vascular pedicle was 12.3±2.5 cm.