The latissimus dorsi-groin-lymph node compound flap: A comprehensive technique with three features including skin coverage, restoration of motor function, and prevention of upper limb lymphedema.
Identifieur interne : 000A05 ( Main/Exploration ); précédent : 000A04; suivant : 000A06The latissimus dorsi-groin-lymph node compound flap: A comprehensive technique with three features including skin coverage, restoration of motor function, and prevention of upper limb lymphedema.
Auteurs : Fabio Nicoli [Taïwan] ; Georgios Orfaniotis [Taïwan] ; Davide Lazzeri [Italie] ; Seong Yoon Lim [Taïwan] ; Kidakorn Kiranantawat [Taïwan] ; Pei-Yu Chen [Taïwan] ; Pedro Ciudad [Taïwan] ; Ram M. Chilgar [Taïwan] ; Stamatis Sapountzis [Taïwan] ; Bulent Sacak [Taïwan] ; Hung-Chi Chen [Taïwan]Source :
- Microsurgery [ 1098-2752 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- Adult, Arm, Forearm, Groin, Humans, Liposarcoma (surgery), Lymph Nodes (surgery), Lymphedema (etiology), Lymphedema (prevention & control), Male, Postoperative Complications (prevention & control), Reconstructive Surgical Procedures (methods), Soft Tissue Neoplasms (surgery), Superficial Back Muscles (surgery), Surgical Flaps.
- MESH :
- etiology : Lymphedema.
- methods : Reconstructive Surgical Procedures.
- prevention & control : Lymphedema, Postoperative Complications.
- surgery : Liposarcoma, Lymph Nodes, Soft Tissue Neoplasms, Superficial Back Muscles.
- Adult, Arm, Forearm, Groin, Humans, Male, Surgical Flaps.
Abstract
Reconstruction of complex upper extremity defects requires a need for multiple tissue components. The supercharged latissimus dorsi (LD)-groin compound flap is an option that can provide a large skin paddle with simultaneous functional muscle transfer. It is necessary to supercharge the flap with the superficial circumflex iliac pedicle to ensure the viability of its groin extension. In this report, we present a case of a supercharged LD-groin flap in combination with vascularized inguinal lymph nodes, which was used for upper limb reconstruction in a young male patient, following excision of high-grade liposarcoma. Resection resulted in a 28 cm × 15 cm skin defect extending from the upper arm to the proximal forearm, also involving the triceps muscle, a segment of the ulnar nerve and the axillary lymph nodes. Restoration of triceps function was achieved with transfer of the innervated LD muscle. Part of the ulnar nerve was resected and repaired with sural nerve grafts. Post-operatively, the flap survived fully with no partial necrosis, and no complications at both the recipient and donor sites. At 1-year follow up, the patient had a well-healed wound with good elbow extension (against resistance), no tumor recurrence, and no signs of lymphedema. We believe this comprehensive approach may represent a valuable technique, for not only the oncological reconstruction of upper extremity, but also for the prevention of lymphedema. © 2015 Wiley Periodicals, Inc. Microsurgery 36:689-694, 2016.
DOI: 10.1002/micr.22515
PubMed: 26466971
Affiliations:
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Chilgar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Sapountzis, Stamatis" sort="Sapountzis, Stamatis" uniqKey="Sapountzis S" first="Stamatis" last="Sapountzis">Stamatis Sapountzis</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Sacak, Bulent" sort="Sacak, Bulent" uniqKey="Sacak B" first="Bulent" last="Sacak">Bulent Sacak</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, 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Orfaniotis</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Lazzeri, Davide" sort="Lazzeri, Davide" uniqKey="Lazzeri D" first="Davide" last="Lazzeri">Davide Lazzeri</name><affiliation wicri:level="3"><nlm:affiliation>Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Lim, Seong Yoon" sort="Lim, Seong Yoon" uniqKey="Lim S" first="Seong Yoon" last="Lim">Seong Yoon Lim</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Kiranantawat, Kidakorn" sort="Kiranantawat, Kidakorn" uniqKey="Kiranantawat K" first="Kidakorn" last="Kiranantawat">Kidakorn Kiranantawat</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Pei Yu" sort="Chen, Pei Yu" uniqKey="Chen P" first="Pei-Yu" last="Chen">Pei-Yu Chen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pathology, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Pathology, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Ciudad, Pedro" sort="Ciudad, Pedro" uniqKey="Ciudad P" first="Pedro" last="Ciudad">Pedro Ciudad</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Chilgar, Ram M" sort="Chilgar, Ram M" uniqKey="Chilgar R" first="Ram M" last="Chilgar">Ram M. Chilgar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Sapountzis, Stamatis" sort="Sapountzis, Stamatis" uniqKey="Sapountzis S" first="Stamatis" last="Sapountzis">Stamatis Sapountzis</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Sacak, Bulent" sort="Sacak, Bulent" uniqKey="Sacak B" first="Bulent" last="Sacak">Bulent Sacak</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author></analytic><series><title level="j">Microsurgery</title><idno type="eISSN">1098-2752</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Arm</term><term>Forearm</term><term>Groin</term><term>Humans</term><term>Liposarcoma (surgery)</term><term>Lymph Nodes (surgery)</term><term>Lymphedema (etiology)</term><term>Lymphedema (prevention & control)</term><term>Male</term><term>Postoperative Complications (prevention & control)</term><term>Reconstructive Surgical Procedures (methods)</term><term>Soft Tissue Neoplasms (surgery)</term><term>Superficial Back Muscles (surgery)</term><term>Surgical Flaps</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Aine</term><term>Avant-bras</term><term>Bras</term><term>Complications postopératoires ()</term><term>Humains</term><term>Lambeaux chirurgicaux</term><term>Liposarcome ()</term><term>Lymphoedème ()</term><term>Lymphoedème (étiologie)</term><term>Muscles superficiels du dos ()</term><term>Mâle</term><term>Noeuds lymphatiques ()</term><term>Procédures de chirurgie reconstructive ()</term><term>Tumeurs des tissus mous ()</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Reconstructive Surgical Procedures</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Lymphedema</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Liposarcoma</term><term>Lymph Nodes</term><term>Soft Tissue Neoplasms</term><term>Superficial Back Muscles</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Arm</term><term>Forearm</term><term>Groin</term><term>Humans</term><term>Male</term><term>Surgical Flaps</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Aine</term><term>Avant-bras</term><term>Bras</term><term>Complications postopératoires</term><term>Humains</term><term>Lambeaux chirurgicaux</term><term>Liposarcome</term><term>Lymphoedème</term><term>Muscles superficiels du dos</term><term>Mâle</term><term>Noeuds lymphatiques</term><term>Procédures de chirurgie reconstructive</term><term>Tumeurs des tissus mous</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Reconstruction of complex upper extremity defects requires a need for multiple tissue components. The supercharged latissimus dorsi (LD)-groin compound flap is an option that can provide a large skin paddle with simultaneous functional muscle transfer. It is necessary to supercharge the flap with the superficial circumflex iliac pedicle to ensure the viability of its groin extension. In this report, we present a case of a supercharged LD-groin flap in combination with vascularized inguinal lymph nodes, which was used for upper limb reconstruction in a young male patient, following excision of high-grade liposarcoma. Resection resulted in a 28 cm × 15 cm skin defect extending from the upper arm to the proximal forearm, also involving the triceps muscle, a segment of the ulnar nerve and the axillary lymph nodes. Restoration of triceps function was achieved with transfer of the innervated LD muscle. Part of the ulnar nerve was resected and repaired with sural nerve grafts. Post-operatively, the flap survived fully with no partial necrosis, and no complications at both the recipient and donor sites. At 1-year follow up, the patient had a well-healed wound with good elbow extension (against resistance), no tumor recurrence, and no signs of lymphedema. We believe this comprehensive approach may represent a valuable technique, for not only the oncological reconstruction of upper extremity, but also for the prevention of lymphedema. © 2015 Wiley Periodicals, Inc. Microsurgery 36:689-694, 2016.</div></front></TEI><affiliations><list><country><li>Italie</li><li>Taïwan</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><country name="Taïwan"><noRegion><name sortKey="Nicoli, Fabio" sort="Nicoli, Fabio" uniqKey="Nicoli F" first="Fabio" last="Nicoli">Fabio Nicoli</name></noRegion><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><name sortKey="Chen, Pei Yu" sort="Chen, Pei Yu" uniqKey="Chen P" first="Pei-Yu" last="Chen">Pei-Yu Chen</name><name sortKey="Chilgar, Ram M" sort="Chilgar, Ram M" uniqKey="Chilgar R" first="Ram M" last="Chilgar">Ram M. Chilgar</name><name sortKey="Ciudad, Pedro" sort="Ciudad, Pedro" uniqKey="Ciudad P" first="Pedro" last="Ciudad">Pedro Ciudad</name><name sortKey="Kiranantawat, Kidakorn" sort="Kiranantawat, Kidakorn" uniqKey="Kiranantawat K" first="Kidakorn" last="Kiranantawat">Kidakorn Kiranantawat</name><name sortKey="Lim, Seong Yoon" sort="Lim, Seong Yoon" uniqKey="Lim S" first="Seong Yoon" last="Lim">Seong Yoon Lim</name><name sortKey="Orfaniotis, Georgios" sort="Orfaniotis, Georgios" uniqKey="Orfaniotis G" first="Georgios" last="Orfaniotis">Georgios Orfaniotis</name><name sortKey="Sacak, Bulent" sort="Sacak, Bulent" uniqKey="Sacak B" first="Bulent" last="Sacak">Bulent Sacak</name><name sortKey="Sapountzis, Stamatis" sort="Sapountzis, Stamatis" uniqKey="Sapountzis S" first="Stamatis" last="Sapountzis">Stamatis Sapountzis</name></country><country name="Italie"><region name="Latium"><name sortKey="Lazzeri, Davide" sort="Lazzeri, Davide" uniqKey="Lazzeri D" first="Davide" last="Lazzeri">Davide Lazzeri</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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