An anatomical study of the relationship between the inferior epigastric artery and rectus abdominis

Musculus rectus abdominis (RA) flebi meme rekonstrüksiyonu için gereken doku hacmine sahip olması ve uygun verici alan morbiditesi nedeniyle yaygın olarak meme,perine ve vagina rekonstriiksiyonlarında kullanılmaktadır. RA flebini kanlandıran arteria epigastrica inferior (AEI), donor damar olarak koroner by pass cerrahisinde ve penis revaskülarizasyonunda da kullanılabilir. Amaç: Bu çalışmanın amacı Türk halkında AEI ve RA arasındaki ilişkinin anatomik profilini sunmaktır. Gereç ve yöntem: Disseksiyoh formalin ile fikse edilmiş 25 adet erişkin insan kadavrasında bilateral 47 adet RA'da gerçekleştirildi. MRA'nın arka yüzünde,AEI'nin gidişi, çapı, kökeni, pedikül uzunluğu, verdiği kütük sayısı ve dallarının lokalizasyonu araştırıldı. , Bulgular: AEI'nin ortalama çapı 3,3 cm'dir ve %63,8 arteria femoralis'ten, %36,2 arteria iliaca externa'dan orijin almaktadır. AEFun ortalama pedikül uzunluğu 12,92 cm'dir. AEI'nin MRA'nın lateral kenarına ulaştığı yerin crista pubica'ya uzaklığı 6,52 cm'dir. MRA'nın arka yüzündeki AEI'ye ait ana dal sayısı %58 oranında tek, %42 iki tanedir. MRA'nın ortalama uzunluğu 34,5 cm olarak hesaplandı. AEI'nin ana dallanma noktası olguların %57,9'unda kasın alt 1/3'ünde, %42,1'inde orta 1/3'ünde yer almaktadır. RA'nm arka yüzü üzerinde AEI'nin ana dallarının sayısı olguların %55,8'inde tek, %40,4'ünde iki, %4,3'üiıde üç tane idi. AEI'nin ana dallarına ayrılma yerinin symphysis pubis'e olan ortalama uzaklığı 12,48 cm, umblicus'a 4,09 cm, arcus costarum'a 17,36 cm olarak ölçüldü.Sonuç: Bu çalışmamızın sonuçları Türk halkında RA ve AEI arasındaki anatomik ilişkinin özelliklerini sunmaktadır. Bu bilgiler flebin ve operasyon sürecinin planlanmasında yararlı olacaktır.

Anahtar Kelimeler:

Rektus abdominis, Anatomi, Kadavra, Cerrahi flepler, Epigastrik arterler

Arteria epigastrica inferior ve musculus rectus abdominis arasındaki ilişkinin anatomik olarak incelenmesi

The rectus abdominis (RA) flap has been widely used in breast, perineum and vagina reconstructions because of as it is a reliable flap with the tissue bulk required in breast reconstruction and with acceptable donor site morbidity.The inferior epigastric artery (IEA), supplying of the RA flap, can be used as a, donor vessel in coronary bypass surgery and penile revascularisation.Objective: The objective of this study is to present the natomical profile of the relationship between the IEA and rectus abdominis (RA). Material and method: Dissection was performed on 47 RA bilaterally in 25 formalin fixed adult human cadavers. The course, diameter, origin, pedicle length,number and distribution of the main branches of the IEA were investigated on the posterior surface of the RA. Results: The mean diameter of the IEA was 3.3 mm and IEA originated from the femoral artery (63.8%) and external iliac artery (36.2%). The mean pedicle length of the IEA was 12.92 cm. The mean distance from the point at which the IEA reaches the lateral margin of the RA to the pubic crest was 6.52 cm. The mean length of the RA was calculated as 34.5 cm. We found that the main branching points of the IEA were localized at the inferior and middle third of the RA as 57.9 % and 42.1 % respectively. The number of the main branches of the IEA on the posterior surface of the RA is one in 55.8 %, two in 40.4 %, three in 4.3 % of all cases.The mean distance from the main branching point of the IEA to the pubic symphysis, to umbilicus and to the costal arch were measured as 12.48 cm, 4.09 cm,17.36 cm respectively. Conclusion: The results of this study presents the properties of the anatomic relationship between the RA and IEA. This data would be helpful fort he planing of the flap and operation process.

Keywords:

Rectus Abdominis, Anatomy, Cadaver, Surgical Flaps, Epigastric Arteries,

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