フクナガ　ユタカ   Yutaka Fukunaga   福永　豊    所属   川崎医科大学  医学部 臨床医学　形成外科学    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Large-to-Small End-to-Side Venous Anastomosis in Free Flap Transfer.
掲載誌名	正式名：The Journal of surgical research 略　 称：J Surg Res ISSNコード：10958673/00224804
掲載区分	国外
巻・号・頁	245,pp.377-382
著者・共著者	Shimpei Miyamoto, Masaki Arikawa, Yu Kagaya, Daisuke Kageyama, Yutaka Fukunaga
発行年月	2020/01
概要	BACKGROUND:Vessel size discrepancy is one of the major risk factors for anastomotic failure in free flap transfer. The situation becomes challenging for reconstructive microsurgeons when the recipient vein is much smaller than the flap vein. We investigated the feasibility of large-to-small end-to-side venous anastomosis for such cases.MATERIALS AND METHODS:The subjects were 16 consecutive patients who underwent a free flap transfer for oncologic defects with a large-to-small end-to-side venous anastomosis. The larger flap vein was anastomosed to the side slit of the smaller recipient vein under an operating microscope. Surgical details and postoperative outcome were investigated retrospectively.RESULTS:An anterolateral thigh flap was used in five patients, a superficial inferior epigastric artery flap in four, a thoracodorsal artery perforator flap in three, and a latissimus dorsi musculocutaneous flap and a fibular osteocutaneous flap in two patients each. The internal mammary vein and the anterior tibial vein were most frequently used as a recipient vein (four patients each), followed by the deep inferior epigastric vein (three patients). The extent of vessel size discrepancy ranged from 1.3- to 3.3-fold, and the mean discrepancy was 1.9-fold. No anastomotic failure occurred postoperatively, and the flap survived in all patients.CONCLUSIONS:Large-to-small end-to-side venous anastomosis can be a versatile option when only a small vein is available as a recipient vein. Internal mammary, deep inferior epigastric, and anterior tibial veins are good candidates for this technique.
DOI	10.1016/j.jss.2019.07.084
PMID	31425879