RESUMO
An accurate preoperative evaluation of the vascular anatomy of the abdominal wall is extremely valuable in improving the surgical strategy in abdominal perforator flaps. The multidetector-row computer tomography offers thin slice coverage of extended volumes with an extremely high spatial resolution. From October 2003 to December 2004, 66 female patients had breast reconstruction surgery in our department using the deep inferior epigastric artery perforator flap. Our multidetector-row computer tomography studies were performed using a 16-detector-row computer tomography scanner. The image assessment was carried out using the following protocol: we first identified the best three perforators from each side of the abdomen. Then we conducted a three-dimensional reconstruction of the abdomen by identifying exactly where the three best perforators emerged from the rectus abdominis fascia. We then transferred the data obtained from the image to the patient using a coordinate system. In addition, we also placed the dominant perforators in the patient by using a conventional hand-held Doppler. During the operation we compared intra-operative findings, Doppler results and computer tomography outcomes. Neither false positive nor false negative results were found in the computer tomography outcome. Multidetector-row computer tomography provides us with an easy method of interpreting the virtual anatomic dissection in three dimensions. It has high sensitivity and specificity and provides a good quality evaluation of the perforator vessels. This information allows reduction of operating time and safer performance of surgery. The multidetector-row computer tomography is a highly effective tool in the preoperative study of abdominal perforator flaps.
Assuntos
Parede Abdominal/irrigação sanguínea , Artérias Epigástricas/cirurgia , Mamoplastia/métodos , Retalhos Cirúrgicos , Tomografia Computadorizada por Raios X/métodos , Abdome/irrigação sanguínea , Feminino , Humanos , Imageamento Tridimensional/métodos , Microcirculação , Cuidados Pré-Operatórios/métodos , Radiografia Abdominal/métodos , Reto do Abdome/diagnóstico por imagemRESUMO
No disponible
Assuntos
Adulto , Feminino , Humanos , Vasculite Associada ao Lúpus do Sistema Nervoso Central , Neurite ÓpticaAssuntos
Doenças dos Nervos Cranianos/etiologia , Síndrome POEMS/complicações , Idoso , Feminino , Humanos , RecidivaRESUMO
A new case of postnephrectomy arteriovenous fistula is reported. This is an uncommon acquired complication of a common surgical procedure. Clinical features, diagnostic procedures, surgical treatment and results are analysed and discussed. In this case, a direct communication between the right renal artery and the inferior vena cava was found.
