Applied Features of Inferior Epigastric Artery Variant Anatomy

Черных, А В; Закурдаев, Е. И.; Yakusheva, N. V.; Витчинкин, В. Г.; Maleev, Yu. V.; Zakurdaeva, M. P.; Andrianova, K. A.; Lazareva, O. A.

doi:10.18499/2225-7357-2016-5-4-74-78

Cited by 4 publications

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“…С использованием данного подхода становится возможным пред-сказывание топографии важного для проведе-ния операции анатомического образования и уменьшение риска его интраоперационного повреждения [10,11,12,13,14].…”

Section: Introductionunclassified

A Method for Preventing of Intraoperative Intercostal Nerve Traumatization at Herniotomy of Umbilical Hernias

Chernyh¹,

Закурдаев²,

Cherednikov³

et al. 2017

Novosti Khirurgii

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ФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко», Российская ФедерацияЦель. Разработать способ прогнозирования количества межреберных нервов у латерального края апо-невротического влагалища прямой мышцы живота в околопупочной области передней брюшной стенки.Материал и методы. Исследовано 88 нефиксированных трупов лиц обоего пола без признаков па-тологии передней брюшной стенки: 45% трупов лиц мужского пола (средний возраст -53,8±11,9 года) и 55% -женского пола (51,9±13,2 года). Измерялись linea bicostalis (расстояние между нижними точками реберных дуг) и linea bispinalis (расстояние между передними верхними остями подвздошных костей). Определялось количество межреберных нервов в области латерального края апоневротического влагалища прямой мышцы живота на протяжении околопупочной области передней брюшной стенки.Результаты. Linea bicostalis в среднем составила 29,2±0,3 см, а linea bispinalis -28,2±0,2 см. В об-ласти латерального края апоневротического влагалища прямой мышцы живота на протяжении околопу-почной области передней брюшной стенки чаще всего наблюдалось 2 пары межреберных нервов (60% наблюдений), несколько реже -1 пара нервов (20%). В 11% к прямой мышце живота подходило 3 пары межреберных нервов, а в 2% случаев встретилось 4 пары нервов. В 7% отмечалось асимметричное количе-ство межреберных нервов. С использованием метода логистической регрессии был предложен способ про-гнозирования вероятности обнаружения 2 пар межреберных нервов в области латерального края апоневро-тического влагалища прямой мышцы живота на протяжении околопупочной области передней брюшной стенки: P(%)=100×(1/(1+e^(12,1+0,33×a1-0,76×a2))), где P -вероятность обнаружения 2 пар межреберных нервов, a1 -linea bispinalis, a2 -linea bicostalis.Заключение. Разработанный способ позволяет прогнозировать количество межреберных нервов у ла-терального края апоневротического влагалища прямой мышцы живота в околопупочной области передней брюшной стенки и может быть рекомендован для применения в клинической практике. Ключевые слова: передняя брюшная стенка, апоневротическое влагалище, прямая мышца, иннервация, межреберные нервы, пупочная грыжа, герниопластикаObjectives. To develop a method of prognostication of the number of intercostal nerves in the lateral edge of the aponeurotic sheath of the rectus abdominis muscle in the umbilical region of the anterior abdominal wall.Methods. The unfixed corpses (n= 88) of both sexes without pathology of the anterior abdominal wall were studied: 45% of male corpses (average age -53,8±11,9 years) and 55% -females (51,9±13,2 years). Linea bicostalis (the distance between the lower points of the costal arches) and linea bispinalis (the distance between the front upper iliac spines) were measured. The number of the intercostal nerves at the lateral edge of the aponeurotic sheath of rectus abdominis muscle in the umbilical region of the anterior abdominal wall was established.Results. Linea bicostalis on the average composed 29,2±0,3 cm and the linea bispinalis -28,2±0,2 cm. In the ar...

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Section: Introductionunclassified

A Method for Preventing of Intraoperative Intercostal Nerve Traumatization at Herniotomy of Umbilical Hernias

Chernyh¹,

Закурдаев²,

Cherednikov³

et al. 2017

Novosti Khirurgii

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A TRAM Flap Harvesting Technique for Breast Reconstruction Surgery after Mastectomy

Chernyh,

Popova,

Yakusheva

et al. 2023

VECS

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Introduction. Currently, the best option for breast reconstruction surgery after mastectomy is TRAM-flap harvesting on a vascular pedicle from the inferior epigastric artery with taking one or two rectus abdominis muscles. However, it is widely reported about cases of marginal necrosis of the lower TRAM flap in the recipient zone. This is due to the area of obstructed blood flow "choke" at the site of anastomosis of the terminal muscular branches of the superior and inferior epigastric arteries.The aim of the study was to investigate the applied topographical features of the lower epigastric arteries in the thickness of the rectus abdominis muscles in women.Materials and methods. The main trunk of the inferior epigastric artery and its terminal branches (III and IV blood supply zones) were dissected on the muscular-aponeurotic flap of the anterior abdominal wall in the thickness of the rectus abdominis muscle in 18 non-fixed female corpses to identify the lower site of arterial anastomosis of the muscular branches. The authors measured the distance from the white line of the abdomen to the point of entry of the studied artery into the thickness of the rectus abdominis muscle, the length of the main trunk, and the vertical distance from the conditional horizontal line drawn through the upper semicircle of the umbilical ring to the beginning of the inferior epigastric artery branching (the "choke" zone). Research results. The length of the major trunk of the inferior epigastric artery from the level of perforation of the posterior wall of the aponeurotic sheath of the rectus abdominis muscle to the beginning of its division averaged 5.70.8 cm. The level of division of the major trunk into muscular branches of the inferior epigastric artery on the left and right, and, consequently, the choke zone, was always higher than the level of the umbilical ring. The distance from the conditional horizontal line drawn through the upper semicircle of the umbilical ring to the beginning of the branching of the major trunk averaged 1.40.9 cm.Conclusion. The data obtained on the typical anatomy of the inferior epigastric arteries in women may allow improving the TRAM flap harvesting on the musculovascular pedicle technique in order to reduce the risk of developing marginal skin necrosis in the recipient zone.

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The Value of the Topography of the Inferior Epigastric Artery in Women in Breast Reconstructive Plastic Surgery

Черных

Popova

Бригадирова

et al. 2021

Žurnal anatomii i gistopatologii

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Currently, the most optimal option for breast reconstruction after mastectomy is the use of a pedicle DIEP flap from the inferior epigastric artery.The aim of the study was to study the features of the typical and variant anatomy of the inferior epigastric artery in women in the applied aspect.Material and methods. The study was carried out on 20 unfixed female bodies who died at the age of 54.6±4.7 years. We studied the level of intersection of the main trunk of the inferior epigastric artery with the lateral edge of the rectus abdominis muscle, the distance from this artery to the midline at different measurement levels, as well as the outer diameter of the studied vessel.Results. On the right, at different measurement levels, the distance from the main trunk of the inferior epigastric artery to the midline, the diameter of the artery, as well as the level of its intersection with the lateral edge of the rectus abdominis muscle in relation to the upper edge of the pubic bone, significantly exceed those on the left.Conclusion. It is necessary to take into account the peculiarities of the topographic anatomy of the inferior epigastric artery, planning and carrying out breast reconstruction with a DIEP flap, in order to prevent the development of necrosis in the postoperative period. For better reperfusion of the reconstruction area in the postoperative period, it is preferable to cut out the flap with the isolation of the right inferior epigastric artery (due to its larger diameter).

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Applied Features of Inferior Epigastric Artery Variant Anatomy

Cited by 4 publications

References 0 publications

A Method for Preventing of Intraoperative Intercostal Nerve Traumatization at Herniotomy of Umbilical Hernias

A Method for Preventing of Intraoperative Intercostal Nerve Traumatization at Herniotomy of Umbilical Hernias

A TRAM Flap Harvesting Technique for Breast Reconstruction Surgery after Mastectomy

The Value of the Topography of the Inferior Epigastric Artery in Women in Breast Reconstructive Plastic Surgery

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