The Experts below are selected from a list of 144 Experts worldwide ranked by ideXlab platform

Xiao Zhou - One of the best experts on this subject based on the ideXlab platform.

  • anatomical research of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast conserving surgery
    Chin J Anat Clin, 2020
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Wen Peng
    Abstract:

    Objective To explore the anatomical basis of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast-conserving surgery. Methods (1)To observe and record the resources and distribution of lateral thoracic Artery in 8 adult specimens. Eight fresh adult cadavers(16 sides), 6 males, 2 females, aged from 28 to 71 years, 39.5 years on average. The specimens were perfused with red gel joining lead oxide via femoral Artery. The occurrence rate, location, course, branch and vascular anastomosis of bilateral lateral thoracic arteries with peripheral blood vessels were dissected from the upper to the clavicle, the lower to the fifth rib, the outer to the axillary front, and the inner to the parasternum. The sources of the lateral thoracic perforator vessels were systematically classified. The outer diameter and pedicle length of the lateral thoracic Artery were measured. (2) From August 2015 to February 2019, 12 cases of early breast cancer patients received breast-conserving surgery and pedicled lateral thoracic Artery perforator flap transfer breast reconstruction in Hunan Province Cancer Hospital. All patients were female. Age ranged from 14 to 52 years old (43.2 years old on average). Eight cases were invasive ductal carcinoma and 4 cases were invasive lobular carcinoma. The locations of the masses were the upper lateral quadrant (n=9), the lower lateral quadrant (n=3). Survival of the flap and the shape of the reconstructed breast were observed after operation. Results Lateral thoracic Artery was observed in 15/16 sides of 8 specimens, pierced between the pectoralis major muscle and latissimus dorsi muscle, outer diameter average of 0.80 mm(0.7-0.9 mm); pedicle length average of 8.15 cm (6.8-10.4cm), had rich vascular anastomosis with the Thoracoacromial Artery, internal mammary Artery, thoracodorsal Artery and intercostal Artery. Lateral thoracic Artery was classified in 6 types, originated from Thoracoacromial Artery (8/15, type Ⅰ), axillary Artery (4/15, type Ⅱ), thoracodorsal Artery (2/15, type Ⅲ), subscapular Artery (1/15, type Ⅳ), multi-resources (1/15, type Ⅴ). In one specimen, lateral thoracic Artery was absent (1/15, type Ⅵ). The average weight of the mass of tumor and breast tissue was 70-95(80.0±5.7)g. Size of the flaps were 10.5-13.5 (11.2±0.4) cm in length, 4.5-7.5 (6.3±0.5) cm in width, and 3.0-4.5(3.4±0.4) cm in thickness. Complications developed in 2 of the cases, fat necrosis in two and wound dehiscence in one, all healed smoothly with dressing treatment. All flaps survived. The reconstructed breasts' shape, texture and elasticity were good. There was no flap contracture deformation in all cases. Only linear scar left in the lateral thoracic donor sites. Function of shoulders were not affected. All 12 patients were followed up for 6 to 20 months (11.5 months on average) with satisfactory results. No recurrence of breast cancer happened. Conclusions The lateral thoracic Artery perforator has variable resources, instant existence and extensive performance. The pedicled lateral thoracic Artery perforator flap can be a useful, alternative and reliable technique in breast reconstruction after breast conserving surgery, especially in laterally located breast cancer. Key words: Breast neoplasms; Mammaplasty; Lateral thoracic Artery; Perforator flap; Breast-conserving surgery

  • clinical application of pedicled chimeric Thoracoacromial Artery perforator flap for circular hypopharyngeal reconstruction
    Chinese Journal of Reparative and Reconstructive Surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To explore the effectiveness of pedicled chimeric Thoracoacromial Artery perforator (TAAP) flap as a reconstructive option for circular hypopharyngeal defects. Methods Between January 2013 and December 2014, the pedicled chimeric TAAP flap was used to repair oncologic circular hypopharyngeal defects in 8 patients, included 6 males and 2 females, with an average age of 57 years (range, 45-80 years). All patients were treated in other hospitals before and recurrence was noted. The duration between latest treatment and recurrence ranged from 3 to 28 months (mean, 16.5 months). According to Union for International Cancer Control (UICC) TNM staged, 3 cases were T 2N 1M 0, 2 cases were T 3N 1M 0, 1 case was T 3N 2M 0, 2 cases were T 4N 1M 0. After laryngectomy, the size of circular hypopharyngeal defect ranged from 9.0 cm×8.5 cm to 12.0 cm×10.5 cm. The size of TAAP flap ranged from 7.0 cm×4.0 cm to 9.5 cm×6.0 cm．The size of pectoralis major flap ranged from 9.0 cm×5.0 cm to 14.5 cm×6.0 cm．The donor sites were closed directly in all cases. Results Postoperatively all flaps survived smoothly, and all defects healed by first intention. No early complication was noted. The mean hospital stay period ranged from 12 to 22 days (mean, 14.5 days). All patients were followed up 12-45 months (mean, 18.7 months). Patients possessed good appearance of surgical sites. No recurrence, fistulas, stenosis/strictures, dehiscence, or swelling occurred. Only linear scars were left on the donor sites, and the pectoralis major muscle function was completely preserved in all patients. Conclusion Patients with high comorbidities may not be suitable candidates for free flap reconstruction, especially when the recipient vessels are affected from disease or radiotherapy. Pedicled chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defects in such conditions．.

  • clinical application of modified bilobed chimeric Thoracoacromial Artery perforator flap for reconstruction of hypopharyngeal defect with anterior neck skin loss
    Chinese journal of otorhinolaryngology head and neck surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To evaluate the efficacy of modified bilobed chimeric Thoracoacromial Artery perforator (TAAP) flap for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Methods Between May 2013 and September 2015, modified bilobed chimeric TAAP flap was used to reconstruct complex oncologic hypopharyngeal defects in 7 patients, including 6 males and 1 female. Patients′ age ranged from 28 to 65 years old (mean age 50±3.4 years old). The size of hypopharyngeal defect ranged from 5.5 cm×3.5 cm to 12.0 cm×4.5 cm, and the size of anterior neck defect ranged from 8.0 cm×4.0 cm to 10.0 cm×4.0 cm. Results The size of TAAP flap was from 6.5 cm×4.0 cm to 13.0 cm×5.0 cm.The size of pectoralis major flap was from 8.0 cm×4.5 cm to 11.0 cm×5.0 cm. The length of pedicle was 6.5-8.5 cm.The distance from pivot point of flap to central point of recipient site was 7.0-9.5 cm.All flaps survived thoroughly, the donor site was closed directly in all cases.The mean hospital stay ranged from 14 to 19 days (mean 15.5 days). The follow-up was 14, 15, 20, 18, 30, 25 and 38 months respectively.Patient possessed good appearance of neck surgical sites, and oral diet was restored in all patients.No recurrence, fistula, stenosis/stricture, dehiscence, or swelling occurred, only with scars left on the donor sites, and pectoralis major muscle function was completely preserved in all patients. Conclusions Modified bilobed chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Key words: Surgical flaps; Reconstructive surgical procedures; Thoracoacromial Artery

  • chimeric Thoracoacromial Artery perforator flap for one staged reconstruction of complex pharyngoesophageal defects a single unit experience
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2018
    Co-Authors: Dajiang Song, Yixin Zhang, Georgios Pafitanis, Luis Parra Pont, Peng Yang, Isao Koshima, Takuya Iida, Xiao Zhou
    Abstract:

    Background Circumferential hypopharyngeal defects with anterior neck skin loss often require double-stacked or chimeric flaps to achieve good surgical outcomes. The Thoracoacromial Artery perforator (TAAP) flap is a simple and reliable method for hypopharyngeal defect reconstruction. Methods From March 2012 to February 2015, 19 male patients with an average age of 62 years (range 42-81 years) underwent complex pharyngoesophageal defect reconstruction with chimeric TAAP flaps. Results All 19 male patients who underwent reconstruction with TAAP flaps achieved optimal functional outcomes. All donor sites were closed primarily. The average length of hospital stay was 12.5 days (range 10-19 days). All patients returned back to normal nutrition after 8 weeks postoperatively. The average follow-up period was 19.3 months (range 14-48 months). Conclusion The chimeric TAAP flap is an innovative local alternative solution for reconstruction of complex circumferential hypopharyngeal defects when free tissue transfer is contraindicated or neck vessels are depleted.

  • clinical application of free Thoracoacromial Artery perforator flap in reconstruction of tongue and mouth floor defects after resection of tongue carcinoma
    Chinese Journal of Reparative and Reconstructive Surgery, 2017
    Co-Authors: Dajiang Song, Zan Li, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Lichang Yang, Chunliu Lu, Wen Peng
    Abstract:

    Objective:To investigate the clinical outcome of free Thoracoacromial Artery perforator (TAAP) flap in the reconstruction of tongue and mouth floor defects after radical resection of tongue carcinoma. Methods:Between May 2010 and February 2015, 11 cases of tongue carcinoma underwent radical resection and reconstruction of tongue and mouth floor defects with free TAAP flaps. The locations of tongue carcinoma were the lingual margin in 7 cases, the ventral tongue in 2 cases, and the mouth floor in 2 cases. According to Union for International Cancer Control (UICC) TNM stage, 3 cases were classified as T 4N 0M 0, 3 cases as T 4N lM 0, 2 cases as T 3N 1M 0, 2 cases as T 3N 2M 0, and 1 case as T 3N 0M 0. The disease duration ranged from 3 to 28 months, 10.6 months on average. The tumor size ranged from 6.0 cm×3 cm to 10 cm×5 cm. The TAAP flap ranged from 7.0 cm×4.0 cm to 11.0 cm×5.5 cm in size, and 0.6-1.2 cm (0.8 cm on average) in thickness, with a pedicle length of 6.8-9.9 cm (7.2 cm on average). Results:All 11 flaps survived, the donor site was closed directly and healed primarily in all cases. The patients were followed up 12-24 months (17.2 months on average). The reconstructed tongue had satisfactory appearance and good functions of swallowing and language. No local recurrence was observed during follow-up. Only linear scar was left at the donor site, and the function of pectoralis major muscle was normal. Conclusion:The TAAP flap is an ideal choice in the reconstruction of tongue defect after resection of tongue carcinoma, which has good texture, appearance, and function results.

Dajiang Song - One of the best experts on this subject based on the ideXlab platform.

  • anatomical research of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast conserving surgery
    Chin J Anat Clin, 2020
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Wen Peng
    Abstract:

    Objective To explore the anatomical basis of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast-conserving surgery. Methods (1)To observe and record the resources and distribution of lateral thoracic Artery in 8 adult specimens. Eight fresh adult cadavers(16 sides), 6 males, 2 females, aged from 28 to 71 years, 39.5 years on average. The specimens were perfused with red gel joining lead oxide via femoral Artery. The occurrence rate, location, course, branch and vascular anastomosis of bilateral lateral thoracic arteries with peripheral blood vessels were dissected from the upper to the clavicle, the lower to the fifth rib, the outer to the axillary front, and the inner to the parasternum. The sources of the lateral thoracic perforator vessels were systematically classified. The outer diameter and pedicle length of the lateral thoracic Artery were measured. (2) From August 2015 to February 2019, 12 cases of early breast cancer patients received breast-conserving surgery and pedicled lateral thoracic Artery perforator flap transfer breast reconstruction in Hunan Province Cancer Hospital. All patients were female. Age ranged from 14 to 52 years old (43.2 years old on average). Eight cases were invasive ductal carcinoma and 4 cases were invasive lobular carcinoma. The locations of the masses were the upper lateral quadrant (n=9), the lower lateral quadrant (n=3). Survival of the flap and the shape of the reconstructed breast were observed after operation. Results Lateral thoracic Artery was observed in 15/16 sides of 8 specimens, pierced between the pectoralis major muscle and latissimus dorsi muscle, outer diameter average of 0.80 mm(0.7-0.9 mm); pedicle length average of 8.15 cm (6.8-10.4cm), had rich vascular anastomosis with the Thoracoacromial Artery, internal mammary Artery, thoracodorsal Artery and intercostal Artery. Lateral thoracic Artery was classified in 6 types, originated from Thoracoacromial Artery (8/15, type Ⅰ), axillary Artery (4/15, type Ⅱ), thoracodorsal Artery (2/15, type Ⅲ), subscapular Artery (1/15, type Ⅳ), multi-resources (1/15, type Ⅴ). In one specimen, lateral thoracic Artery was absent (1/15, type Ⅵ). The average weight of the mass of tumor and breast tissue was 70-95(80.0±5.7)g. Size of the flaps were 10.5-13.5 (11.2±0.4) cm in length, 4.5-7.5 (6.3±0.5) cm in width, and 3.0-4.5(3.4±0.4) cm in thickness. Complications developed in 2 of the cases, fat necrosis in two and wound dehiscence in one, all healed smoothly with dressing treatment. All flaps survived. The reconstructed breasts' shape, texture and elasticity were good. There was no flap contracture deformation in all cases. Only linear scar left in the lateral thoracic donor sites. Function of shoulders were not affected. All 12 patients were followed up for 6 to 20 months (11.5 months on average) with satisfactory results. No recurrence of breast cancer happened. Conclusions The lateral thoracic Artery perforator has variable resources, instant existence and extensive performance. The pedicled lateral thoracic Artery perforator flap can be a useful, alternative and reliable technique in breast reconstruction after breast conserving surgery, especially in laterally located breast cancer. Key words: Breast neoplasms; Mammaplasty; Lateral thoracic Artery; Perforator flap; Breast-conserving surgery

  • clinical application of pedicled chimeric Thoracoacromial Artery perforator flap for circular hypopharyngeal reconstruction
    Chinese Journal of Reparative and Reconstructive Surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To explore the effectiveness of pedicled chimeric Thoracoacromial Artery perforator (TAAP) flap as a reconstructive option for circular hypopharyngeal defects. Methods Between January 2013 and December 2014, the pedicled chimeric TAAP flap was used to repair oncologic circular hypopharyngeal defects in 8 patients, included 6 males and 2 females, with an average age of 57 years (range, 45-80 years). All patients were treated in other hospitals before and recurrence was noted. The duration between latest treatment and recurrence ranged from 3 to 28 months (mean, 16.5 months). According to Union for International Cancer Control (UICC) TNM staged, 3 cases were T 2N 1M 0, 2 cases were T 3N 1M 0, 1 case was T 3N 2M 0, 2 cases were T 4N 1M 0. After laryngectomy, the size of circular hypopharyngeal defect ranged from 9.0 cm×8.5 cm to 12.0 cm×10.5 cm. The size of TAAP flap ranged from 7.0 cm×4.0 cm to 9.5 cm×6.0 cm．The size of pectoralis major flap ranged from 9.0 cm×5.0 cm to 14.5 cm×6.0 cm．The donor sites were closed directly in all cases. Results Postoperatively all flaps survived smoothly, and all defects healed by first intention. No early complication was noted. The mean hospital stay period ranged from 12 to 22 days (mean, 14.5 days). All patients were followed up 12-45 months (mean, 18.7 months). Patients possessed good appearance of surgical sites. No recurrence, fistulas, stenosis/strictures, dehiscence, or swelling occurred. Only linear scars were left on the donor sites, and the pectoralis major muscle function was completely preserved in all patients. Conclusion Patients with high comorbidities may not be suitable candidates for free flap reconstruction, especially when the recipient vessels are affected from disease or radiotherapy. Pedicled chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defects in such conditions．.

  • clinical application of modified bilobed chimeric Thoracoacromial Artery perforator flap for reconstruction of hypopharyngeal defect with anterior neck skin loss
    Chinese journal of otorhinolaryngology head and neck surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To evaluate the efficacy of modified bilobed chimeric Thoracoacromial Artery perforator (TAAP) flap for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Methods Between May 2013 and September 2015, modified bilobed chimeric TAAP flap was used to reconstruct complex oncologic hypopharyngeal defects in 7 patients, including 6 males and 1 female. Patients′ age ranged from 28 to 65 years old (mean age 50±3.4 years old). The size of hypopharyngeal defect ranged from 5.5 cm×3.5 cm to 12.0 cm×4.5 cm, and the size of anterior neck defect ranged from 8.0 cm×4.0 cm to 10.0 cm×4.0 cm. Results The size of TAAP flap was from 6.5 cm×4.0 cm to 13.0 cm×5.0 cm.The size of pectoralis major flap was from 8.0 cm×4.5 cm to 11.0 cm×5.0 cm. The length of pedicle was 6.5-8.5 cm.The distance from pivot point of flap to central point of recipient site was 7.0-9.5 cm.All flaps survived thoroughly, the donor site was closed directly in all cases.The mean hospital stay ranged from 14 to 19 days (mean 15.5 days). The follow-up was 14, 15, 20, 18, 30, 25 and 38 months respectively.Patient possessed good appearance of neck surgical sites, and oral diet was restored in all patients.No recurrence, fistula, stenosis/stricture, dehiscence, or swelling occurred, only with scars left on the donor sites, and pectoralis major muscle function was completely preserved in all patients. Conclusions Modified bilobed chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Key words: Surgical flaps; Reconstructive surgical procedures; Thoracoacromial Artery

  • chimeric Thoracoacromial Artery perforator flap for one staged reconstruction of complex pharyngoesophageal defects a single unit experience
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2018
    Co-Authors: Dajiang Song, Yixin Zhang, Georgios Pafitanis, Luis Parra Pont, Peng Yang, Isao Koshima, Takuya Iida, Xiao Zhou
    Abstract:

    Background Circumferential hypopharyngeal defects with anterior neck skin loss often require double-stacked or chimeric flaps to achieve good surgical outcomes. The Thoracoacromial Artery perforator (TAAP) flap is a simple and reliable method for hypopharyngeal defect reconstruction. Methods From March 2012 to February 2015, 19 male patients with an average age of 62 years (range 42-81 years) underwent complex pharyngoesophageal defect reconstruction with chimeric TAAP flaps. Results All 19 male patients who underwent reconstruction with TAAP flaps achieved optimal functional outcomes. All donor sites were closed primarily. The average length of hospital stay was 12.5 days (range 10-19 days). All patients returned back to normal nutrition after 8 weeks postoperatively. The average follow-up period was 19.3 months (range 14-48 months). Conclusion The chimeric TAAP flap is an innovative local alternative solution for reconstruction of complex circumferential hypopharyngeal defects when free tissue transfer is contraindicated or neck vessels are depleted.

  • clinical application of free Thoracoacromial Artery perforator flap in reconstruction of tongue and mouth floor defects after resection of tongue carcinoma
    Chinese Journal of Reparative and Reconstructive Surgery, 2017
    Co-Authors: Dajiang Song, Zan Li, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Lichang Yang, Chunliu Lu, Wen Peng
    Abstract:

    Objective:To investigate the clinical outcome of free Thoracoacromial Artery perforator (TAAP) flap in the reconstruction of tongue and mouth floor defects after radical resection of tongue carcinoma. Methods:Between May 2010 and February 2015, 11 cases of tongue carcinoma underwent radical resection and reconstruction of tongue and mouth floor defects with free TAAP flaps. The locations of tongue carcinoma were the lingual margin in 7 cases, the ventral tongue in 2 cases, and the mouth floor in 2 cases. According to Union for International Cancer Control (UICC) TNM stage, 3 cases were classified as T 4N 0M 0, 3 cases as T 4N lM 0, 2 cases as T 3N 1M 0, 2 cases as T 3N 2M 0, and 1 case as T 3N 0M 0. The disease duration ranged from 3 to 28 months, 10.6 months on average. The tumor size ranged from 6.0 cm×3 cm to 10 cm×5 cm. The TAAP flap ranged from 7.0 cm×4.0 cm to 11.0 cm×5.5 cm in size, and 0.6-1.2 cm (0.8 cm on average) in thickness, with a pedicle length of 6.8-9.9 cm (7.2 cm on average). Results:All 11 flaps survived, the donor site was closed directly and healed primarily in all cases. The patients were followed up 12-24 months (17.2 months on average). The reconstructed tongue had satisfactory appearance and good functions of swallowing and language. No local recurrence was observed during follow-up. Only linear scar was left at the donor site, and the function of pectoralis major muscle was normal. Conclusion:The TAAP flap is an ideal choice in the reconstruction of tongue defect after resection of tongue carcinoma, which has good texture, appearance, and function results.

Yixin Zhang - One of the best experts on this subject based on the ideXlab platform.

  • anatomical research of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast conserving surgery
    Chin J Anat Clin, 2020
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Wen Peng
    Abstract:

    Objective To explore the anatomical basis of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast-conserving surgery. Methods (1)To observe and record the resources and distribution of lateral thoracic Artery in 8 adult specimens. Eight fresh adult cadavers(16 sides), 6 males, 2 females, aged from 28 to 71 years, 39.5 years on average. The specimens were perfused with red gel joining lead oxide via femoral Artery. The occurrence rate, location, course, branch and vascular anastomosis of bilateral lateral thoracic arteries with peripheral blood vessels were dissected from the upper to the clavicle, the lower to the fifth rib, the outer to the axillary front, and the inner to the parasternum. The sources of the lateral thoracic perforator vessels were systematically classified. The outer diameter and pedicle length of the lateral thoracic Artery were measured. (2) From August 2015 to February 2019, 12 cases of early breast cancer patients received breast-conserving surgery and pedicled lateral thoracic Artery perforator flap transfer breast reconstruction in Hunan Province Cancer Hospital. All patients were female. Age ranged from 14 to 52 years old (43.2 years old on average). Eight cases were invasive ductal carcinoma and 4 cases were invasive lobular carcinoma. The locations of the masses were the upper lateral quadrant (n=9), the lower lateral quadrant (n=3). Survival of the flap and the shape of the reconstructed breast were observed after operation. Results Lateral thoracic Artery was observed in 15/16 sides of 8 specimens, pierced between the pectoralis major muscle and latissimus dorsi muscle, outer diameter average of 0.80 mm(0.7-0.9 mm); pedicle length average of 8.15 cm (6.8-10.4cm), had rich vascular anastomosis with the Thoracoacromial Artery, internal mammary Artery, thoracodorsal Artery and intercostal Artery. Lateral thoracic Artery was classified in 6 types, originated from Thoracoacromial Artery (8/15, type Ⅰ), axillary Artery (4/15, type Ⅱ), thoracodorsal Artery (2/15, type Ⅲ), subscapular Artery (1/15, type Ⅳ), multi-resources (1/15, type Ⅴ). In one specimen, lateral thoracic Artery was absent (1/15, type Ⅵ). The average weight of the mass of tumor and breast tissue was 70-95(80.0±5.7)g. Size of the flaps were 10.5-13.5 (11.2±0.4) cm in length, 4.5-7.5 (6.3±0.5) cm in width, and 3.0-4.5(3.4±0.4) cm in thickness. Complications developed in 2 of the cases, fat necrosis in two and wound dehiscence in one, all healed smoothly with dressing treatment. All flaps survived. The reconstructed breasts' shape, texture and elasticity were good. There was no flap contracture deformation in all cases. Only linear scar left in the lateral thoracic donor sites. Function of shoulders were not affected. All 12 patients were followed up for 6 to 20 months (11.5 months on average) with satisfactory results. No recurrence of breast cancer happened. Conclusions The lateral thoracic Artery perforator has variable resources, instant existence and extensive performance. The pedicled lateral thoracic Artery perforator flap can be a useful, alternative and reliable technique in breast reconstruction after breast conserving surgery, especially in laterally located breast cancer. Key words: Breast neoplasms; Mammaplasty; Lateral thoracic Artery; Perforator flap; Breast-conserving surgery

  • clinical application of pedicled chimeric Thoracoacromial Artery perforator flap for circular hypopharyngeal reconstruction
    Chinese Journal of Reparative and Reconstructive Surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To explore the effectiveness of pedicled chimeric Thoracoacromial Artery perforator (TAAP) flap as a reconstructive option for circular hypopharyngeal defects. Methods Between January 2013 and December 2014, the pedicled chimeric TAAP flap was used to repair oncologic circular hypopharyngeal defects in 8 patients, included 6 males and 2 females, with an average age of 57 years (range, 45-80 years). All patients were treated in other hospitals before and recurrence was noted. The duration between latest treatment and recurrence ranged from 3 to 28 months (mean, 16.5 months). According to Union for International Cancer Control (UICC) TNM staged, 3 cases were T 2N 1M 0, 2 cases were T 3N 1M 0, 1 case was T 3N 2M 0, 2 cases were T 4N 1M 0. After laryngectomy, the size of circular hypopharyngeal defect ranged from 9.0 cm×8.5 cm to 12.0 cm×10.5 cm. The size of TAAP flap ranged from 7.0 cm×4.0 cm to 9.5 cm×6.0 cm．The size of pectoralis major flap ranged from 9.0 cm×5.0 cm to 14.5 cm×6.0 cm．The donor sites were closed directly in all cases. Results Postoperatively all flaps survived smoothly, and all defects healed by first intention. No early complication was noted. The mean hospital stay period ranged from 12 to 22 days (mean, 14.5 days). All patients were followed up 12-45 months (mean, 18.7 months). Patients possessed good appearance of surgical sites. No recurrence, fistulas, stenosis/strictures, dehiscence, or swelling occurred. Only linear scars were left on the donor sites, and the pectoralis major muscle function was completely preserved in all patients. Conclusion Patients with high comorbidities may not be suitable candidates for free flap reconstruction, especially when the recipient vessels are affected from disease or radiotherapy. Pedicled chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defects in such conditions．.

  • clinical application of modified bilobed chimeric Thoracoacromial Artery perforator flap for reconstruction of hypopharyngeal defect with anterior neck skin loss
    Chinese journal of otorhinolaryngology head and neck surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To evaluate the efficacy of modified bilobed chimeric Thoracoacromial Artery perforator (TAAP) flap for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Methods Between May 2013 and September 2015, modified bilobed chimeric TAAP flap was used to reconstruct complex oncologic hypopharyngeal defects in 7 patients, including 6 males and 1 female. Patients′ age ranged from 28 to 65 years old (mean age 50±3.4 years old). The size of hypopharyngeal defect ranged from 5.5 cm×3.5 cm to 12.0 cm×4.5 cm, and the size of anterior neck defect ranged from 8.0 cm×4.0 cm to 10.0 cm×4.0 cm. Results The size of TAAP flap was from 6.5 cm×4.0 cm to 13.0 cm×5.0 cm.The size of pectoralis major flap was from 8.0 cm×4.5 cm to 11.0 cm×5.0 cm. The length of pedicle was 6.5-8.5 cm.The distance from pivot point of flap to central point of recipient site was 7.0-9.5 cm.All flaps survived thoroughly, the donor site was closed directly in all cases.The mean hospital stay ranged from 14 to 19 days (mean 15.5 days). The follow-up was 14, 15, 20, 18, 30, 25 and 38 months respectively.Patient possessed good appearance of neck surgical sites, and oral diet was restored in all patients.No recurrence, fistula, stenosis/stricture, dehiscence, or swelling occurred, only with scars left on the donor sites, and pectoralis major muscle function was completely preserved in all patients. Conclusions Modified bilobed chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Key words: Surgical flaps; Reconstructive surgical procedures; Thoracoacromial Artery

  • chimeric Thoracoacromial Artery perforator flap for one staged reconstruction of complex pharyngoesophageal defects a single unit experience
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2018
    Co-Authors: Dajiang Song, Yixin Zhang, Georgios Pafitanis, Luis Parra Pont, Peng Yang, Isao Koshima, Takuya Iida, Xiao Zhou
    Abstract:

    Background Circumferential hypopharyngeal defects with anterior neck skin loss often require double-stacked or chimeric flaps to achieve good surgical outcomes. The Thoracoacromial Artery perforator (TAAP) flap is a simple and reliable method for hypopharyngeal defect reconstruction. Methods From March 2012 to February 2015, 19 male patients with an average age of 62 years (range 42-81 years) underwent complex pharyngoesophageal defect reconstruction with chimeric TAAP flaps. Results All 19 male patients who underwent reconstruction with TAAP flaps achieved optimal functional outcomes. All donor sites were closed primarily. The average length of hospital stay was 12.5 days (range 10-19 days). All patients returned back to normal nutrition after 8 weeks postoperatively. The average follow-up period was 19.3 months (range 14-48 months). Conclusion The chimeric TAAP flap is an innovative local alternative solution for reconstruction of complex circumferential hypopharyngeal defects when free tissue transfer is contraindicated or neck vessels are depleted.

  • clinical application of free Thoracoacromial Artery perforator flap in reconstruction of tongue and mouth floor defects after resection of tongue carcinoma
    Chinese Journal of Reparative and Reconstructive Surgery, 2017
    Co-Authors: Dajiang Song, Zan Li, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Lichang Yang, Chunliu Lu, Wen Peng
    Abstract:

    Objective:To investigate the clinical outcome of free Thoracoacromial Artery perforator (TAAP) flap in the reconstruction of tongue and mouth floor defects after radical resection of tongue carcinoma. Methods:Between May 2010 and February 2015, 11 cases of tongue carcinoma underwent radical resection and reconstruction of tongue and mouth floor defects with free TAAP flaps. The locations of tongue carcinoma were the lingual margin in 7 cases, the ventral tongue in 2 cases, and the mouth floor in 2 cases. According to Union for International Cancer Control (UICC) TNM stage, 3 cases were classified as T 4N 0M 0, 3 cases as T 4N lM 0, 2 cases as T 3N 1M 0, 2 cases as T 3N 2M 0, and 1 case as T 3N 0M 0. The disease duration ranged from 3 to 28 months, 10.6 months on average. The tumor size ranged from 6.0 cm×3 cm to 10 cm×5 cm. The TAAP flap ranged from 7.0 cm×4.0 cm to 11.0 cm×5.5 cm in size, and 0.6-1.2 cm (0.8 cm on average) in thickness, with a pedicle length of 6.8-9.9 cm (7.2 cm on average). Results:All 11 flaps survived, the donor site was closed directly and healed primarily in all cases. The patients were followed up 12-24 months (17.2 months on average). The reconstructed tongue had satisfactory appearance and good functions of swallowing and language. No local recurrence was observed during follow-up. Only linear scar was left at the donor site, and the function of pectoralis major muscle was normal. Conclusion:The TAAP flap is an ideal choice in the reconstruction of tongue defect after resection of tongue carcinoma, which has good texture, appearance, and function results.

Wen Peng - One of the best experts on this subject based on the ideXlab platform.

  • anatomical research of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast conserving surgery
    Chin J Anat Clin, 2020
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Wen Peng
    Abstract:

    Objective To explore the anatomical basis of pedicled lateral thoracic Artery perforator flap in breast reconstruction after breast-conserving surgery. Methods (1)To observe and record the resources and distribution of lateral thoracic Artery in 8 adult specimens. Eight fresh adult cadavers(16 sides), 6 males, 2 females, aged from 28 to 71 years, 39.5 years on average. The specimens were perfused with red gel joining lead oxide via femoral Artery. The occurrence rate, location, course, branch and vascular anastomosis of bilateral lateral thoracic arteries with peripheral blood vessels were dissected from the upper to the clavicle, the lower to the fifth rib, the outer to the axillary front, and the inner to the parasternum. The sources of the lateral thoracic perforator vessels were systematically classified. The outer diameter and pedicle length of the lateral thoracic Artery were measured. (2) From August 2015 to February 2019, 12 cases of early breast cancer patients received breast-conserving surgery and pedicled lateral thoracic Artery perforator flap transfer breast reconstruction in Hunan Province Cancer Hospital. All patients were female. Age ranged from 14 to 52 years old (43.2 years old on average). Eight cases were invasive ductal carcinoma and 4 cases were invasive lobular carcinoma. The locations of the masses were the upper lateral quadrant (n=9), the lower lateral quadrant (n=3). Survival of the flap and the shape of the reconstructed breast were observed after operation. Results Lateral thoracic Artery was observed in 15/16 sides of 8 specimens, pierced between the pectoralis major muscle and latissimus dorsi muscle, outer diameter average of 0.80 mm(0.7-0.9 mm); pedicle length average of 8.15 cm (6.8-10.4cm), had rich vascular anastomosis with the Thoracoacromial Artery, internal mammary Artery, thoracodorsal Artery and intercostal Artery. Lateral thoracic Artery was classified in 6 types, originated from Thoracoacromial Artery (8/15, type Ⅰ), axillary Artery (4/15, type Ⅱ), thoracodorsal Artery (2/15, type Ⅲ), subscapular Artery (1/15, type Ⅳ), multi-resources (1/15, type Ⅴ). In one specimen, lateral thoracic Artery was absent (1/15, type Ⅵ). The average weight of the mass of tumor and breast tissue was 70-95(80.0±5.7)g. Size of the flaps were 10.5-13.5 (11.2±0.4) cm in length, 4.5-7.5 (6.3±0.5) cm in width, and 3.0-4.5(3.4±0.4) cm in thickness. Complications developed in 2 of the cases, fat necrosis in two and wound dehiscence in one, all healed smoothly with dressing treatment. All flaps survived. The reconstructed breasts' shape, texture and elasticity were good. There was no flap contracture deformation in all cases. Only linear scar left in the lateral thoracic donor sites. Function of shoulders were not affected. All 12 patients were followed up for 6 to 20 months (11.5 months on average) with satisfactory results. No recurrence of breast cancer happened. Conclusions The lateral thoracic Artery perforator has variable resources, instant existence and extensive performance. The pedicled lateral thoracic Artery perforator flap can be a useful, alternative and reliable technique in breast reconstruction after breast conserving surgery, especially in laterally located breast cancer. Key words: Breast neoplasms; Mammaplasty; Lateral thoracic Artery; Perforator flap; Breast-conserving surgery

  • clinical application of pedicled chimeric Thoracoacromial Artery perforator flap for circular hypopharyngeal reconstruction
    Chinese Journal of Reparative and Reconstructive Surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To explore the effectiveness of pedicled chimeric Thoracoacromial Artery perforator (TAAP) flap as a reconstructive option for circular hypopharyngeal defects. Methods Between January 2013 and December 2014, the pedicled chimeric TAAP flap was used to repair oncologic circular hypopharyngeal defects in 8 patients, included 6 males and 2 females, with an average age of 57 years (range, 45-80 years). All patients were treated in other hospitals before and recurrence was noted. The duration between latest treatment and recurrence ranged from 3 to 28 months (mean, 16.5 months). According to Union for International Cancer Control (UICC) TNM staged, 3 cases were T 2N 1M 0, 2 cases were T 3N 1M 0, 1 case was T 3N 2M 0, 2 cases were T 4N 1M 0. After laryngectomy, the size of circular hypopharyngeal defect ranged from 9.0 cm×8.5 cm to 12.0 cm×10.5 cm. The size of TAAP flap ranged from 7.0 cm×4.0 cm to 9.5 cm×6.0 cm．The size of pectoralis major flap ranged from 9.0 cm×5.0 cm to 14.5 cm×6.0 cm．The donor sites were closed directly in all cases. Results Postoperatively all flaps survived smoothly, and all defects healed by first intention. No early complication was noted. The mean hospital stay period ranged from 12 to 22 days (mean, 14.5 days). All patients were followed up 12-45 months (mean, 18.7 months). Patients possessed good appearance of surgical sites. No recurrence, fistulas, stenosis/strictures, dehiscence, or swelling occurred. Only linear scars were left on the donor sites, and the pectoralis major muscle function was completely preserved in all patients. Conclusion Patients with high comorbidities may not be suitable candidates for free flap reconstruction, especially when the recipient vessels are affected from disease or radiotherapy. Pedicled chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defects in such conditions．.

  • clinical application of modified bilobed chimeric Thoracoacromial Artery perforator flap for reconstruction of hypopharyngeal defect with anterior neck skin loss
    Chinese journal of otorhinolaryngology head and neck surgery, 2018
    Co-Authors: Dajiang Song, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Wen Peng, Huangxing Mao, Chunliu Lyu, Yuanyuan Tang, Zeyang Liu
    Abstract:

    Objective To evaluate the efficacy of modified bilobed chimeric Thoracoacromial Artery perforator (TAAP) flap for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Methods Between May 2013 and September 2015, modified bilobed chimeric TAAP flap was used to reconstruct complex oncologic hypopharyngeal defects in 7 patients, including 6 males and 1 female. Patients′ age ranged from 28 to 65 years old (mean age 50±3.4 years old). The size of hypopharyngeal defect ranged from 5.5 cm×3.5 cm to 12.0 cm×4.5 cm, and the size of anterior neck defect ranged from 8.0 cm×4.0 cm to 10.0 cm×4.0 cm. Results The size of TAAP flap was from 6.5 cm×4.0 cm to 13.0 cm×5.0 cm.The size of pectoralis major flap was from 8.0 cm×4.5 cm to 11.0 cm×5.0 cm. The length of pedicle was 6.5-8.5 cm.The distance from pivot point of flap to central point of recipient site was 7.0-9.5 cm.All flaps survived thoroughly, the donor site was closed directly in all cases.The mean hospital stay ranged from 14 to 19 days (mean 15.5 days). The follow-up was 14, 15, 20, 18, 30, 25 and 38 months respectively.Patient possessed good appearance of neck surgical sites, and oral diet was restored in all patients.No recurrence, fistula, stenosis/stricture, dehiscence, or swelling occurred, only with scars left on the donor sites, and pectoralis major muscle function was completely preserved in all patients. Conclusions Modified bilobed chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defect with anterior neck skin loss. Key words: Surgical flaps; Reconstructive surgical procedures; Thoracoacromial Artery

  • clinical application of free Thoracoacromial Artery perforator flap in reconstruction of tongue and mouth floor defects after resection of tongue carcinoma
    Chinese Journal of Reparative and Reconstructive Surgery, 2017
    Co-Authors: Dajiang Song, Zan Li, Xiao Zhou, Yixin Zhang, Xiaowei Peng, Bo Zhou, Lichang Yang, Chunliu Lu, Wen Peng
    Abstract:

    Objective:To investigate the clinical outcome of free Thoracoacromial Artery perforator (TAAP) flap in the reconstruction of tongue and mouth floor defects after radical resection of tongue carcinoma. Methods:Between May 2010 and February 2015, 11 cases of tongue carcinoma underwent radical resection and reconstruction of tongue and mouth floor defects with free TAAP flaps. The locations of tongue carcinoma were the lingual margin in 7 cases, the ventral tongue in 2 cases, and the mouth floor in 2 cases. According to Union for International Cancer Control (UICC) TNM stage, 3 cases were classified as T 4N 0M 0, 3 cases as T 4N lM 0, 2 cases as T 3N 1M 0, 2 cases as T 3N 2M 0, and 1 case as T 3N 0M 0. The disease duration ranged from 3 to 28 months, 10.6 months on average. The tumor size ranged from 6.0 cm×3 cm to 10 cm×5 cm. The TAAP flap ranged from 7.0 cm×4.0 cm to 11.0 cm×5.5 cm in size, and 0.6-1.2 cm (0.8 cm on average) in thickness, with a pedicle length of 6.8-9.9 cm (7.2 cm on average). Results:All 11 flaps survived, the donor site was closed directly and healed primarily in all cases. The patients were followed up 12-24 months (17.2 months on average). The reconstructed tongue had satisfactory appearance and good functions of swallowing and language. No local recurrence was observed during follow-up. Only linear scar was left at the donor site, and the function of pectoralis major muscle was normal. Conclusion:The TAAP flap is an ideal choice in the reconstruction of tongue defect after resection of tongue carcinoma, which has good texture, appearance, and function results.

Garry Buckland - One of the best experts on this subject based on the ideXlab platform.

  • A Novel Technique of Intraoperative Lateral Pectoral Nerve Block During Subpectoral Breast Implant Placement.
    Plastic and reconstructive surgery. Global open, 2016
    Co-Authors: Nicholas Bernard Haydon, Rhys Van Der Rijt, Catherine Downs, Garry Buckland
    Abstract:

    We report a novel technique of intraoperative lateral pectoral nerve block under direct vision for analgesia after subpectoral implant placement for breast reconstruction. Breast surgery is one of the most frequently performed surgeries in hospitals, and even minor breast surgery can be associated with significant postoperative pain.1 Blanco et al2 describe the “pecs block” of the lateral pectoral nerve under ultrasound guidance, which was found to be particularly useful for patients who have had breast expanders and implants. Similarly, Semenza3 reported a case of successful ultrasound-guided blockade of the lateral pectoral nerve to improve postoperative analgesia after submuscular breast augmentation. Leiman et al4 report blockade of the medial and lateral pectoral nerves under ultrasound guidance that results in complete relaxation of the pectoralis major and reduction in postoperative pain. The paravertebral approach providing multilevel intercostal nerve block is another technique providing a similar level of analgesia that we have used for such breast cases. It also provides excellent analgesia, similar to that seen with skin infiltration plus lateral pectoral nerve block but accessing the paravertebral or intercostal space always carries a small risk of accidental pneumothorax.5 Although thoracic intercostal nerves provide sensory innervation to the breast, significant pain afferents from the muscle are carried by the lateral pectoral nerve after submuscular prosthesis placement.3 The pectoralis major muscle is principally supplied by the lateral pectoral nerve via spinal segments C5, C6, and C7 and the medial pectoral nerve (C8, T1). The lateral pectoral nerve is readily visualized emerging from the clavipectoral fascia along with the pectoral branch of the Thoracoacromial Artery during elevation of the pectoralis major muscle; the medial pectoral nerve (C8, T1) pierces pectoralis minor to run on the undersurface of pectoralis major and supplies the lower costal fibers.6 Submuscular implant placement, therefore, provides an opportune time to block the lateral pectoral nerve (and communicating fibers from medial pectoral nerve) intraoperatively. During surgery, for postmastectomy breast reconstruction or cosmetic subpectoral implants, the pectoralis major muscle is elevated from its inferolateral aspect. Once the muscle is dissected off its costal attachments, blunt dissection is carried out until the lateral pectoral nerve is visualized emerging from the clavipectoral fascia. Using a blunt tip cannula, 10 mL of 0.75% ropivacaine is infiltrated around the lateral pectoral nerve under direct visualization. Blockade of the nerve is conducted just before implant placement (Fig. ​(Fig.11). Fig. 1. Schematic demonstrating the lateral pectoral nerve emerging from the clavipectoral fascia with the pectoral branch of the Thoracoacromial Artery and the cephalic vein (pectoralis major muscle cut and reflected). We routinely do this procedure on all subpectoral prosthetic breast reconstructions and subpectoral breast augmentation and agree with Blanco et al2 that it significantly reduces postoperative pain and opiate requirements. Before introduction of the lateral pectoral nerve block, our usual practice was to prescribe regular paracetamol and COX 2 NSAID with a patient controlled analgesia device containing fentanyl. With the use of routine lateral pectoral nerve block performed by the surgeon before insertion of the subpectoral prosthesis, most of our patients no longer utilize the patient controlled analgesia device and manage their postoperative pain with paracetamol and NSAIDS with the additional likely benefit of reducing the opiate-related side effects of sedation, nausea, and constipation. Further studies should quantify the efficacy of this block by assessing postoperative opiate requirements and patient satisfaction (Fig. ​(Fig.22). Fig. 2. Intraoperative image—left breast inframammary fold incision, visualizing the lateral pectoral nerve on the undersurface of the pectoralis major muscle.