Video-assisted harvesting of anterolateral thigh free flap: technique validation and initial results.
Otolaryngol Head Neck Surg
; 149(2): 219-25, 2013 Aug.
Article
en En
| MEDLINE
| ID: mdl-23629969
OBJECTIVE: To provide a description of a minimally invasive, video-assisted technique (VAT) to identify the cutaneous perforators of the anterolateral thigh (ALT). The objective of the study was to compare this technique with standard open exploration of the thigh and to describe the learning curve for the procedure. STUDY DESIGN: Case series with chart review. SETTING: Academic tertiary institution. SUBJECTS AND METHODS: Twenty-six cases operated between December 2009 and June 2012. In all of these cases, an open thigh exploration, considered the gold standard, was performed immediately after the VAT. Data retrieved included surgical findings, demographics, and outcomes. RESULTS: There were 17 men and 9 women with a mean age of 60 years. The average flap size was 91 cm(2) (range, 39-264 cm(2)), and a chimeric double skin paddle flap was harvested in 6 cases. Forty-nine of 53 total perforators were successfully identified endoscopically. Findings on endoscopic and open exploration were highly correlated (r = 0.92, P = .000). The overall sensitivity for the technique was 92.4% (confidence interval, 80.9-97.5) but reached 100% for perforators located at the midpoint of the anterior-superior iliac spine-patella line. All flaps survived, and there were no technique-related complications. The learning curve plateaued after 15 cases, with a mean endoscopic operative time of 18.2 minutes for the last 10 procedures. CONCLUSION: This VAT is a safe and reliable method to identify cutaneous perforators of the lateral thigh. The procedure is straightforward and has a moderate learning curve. This approach has a role in minimizing donor site morbidity and assisting in flap design.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Muslo
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Traumatismos de los Tejidos Blandos
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Traumatismos del Cuello
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Cirugía Asistida por Video
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Recolección de Tejidos y Órganos
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Endoscopía
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Colgajos Tisulares Libres
Tipo de estudio:
Observational_studies
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Prognostic_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Asunto de la revista:
OTORRINOLARINGOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Reino Unido