Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Reconstruction of Extensive Diaphragmatic Defects Using the Rectus Abdominis Muscle and Fascial Flap

  • Shumpei Kato (Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College) ;
  • Hisashi Sakuma (Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College) ;
  • Takako Fujii (Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College) ;
  • Ichiro Tanaka (Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College) ;
  • Junichi Matsui (Department of Surgery, Ichikawa General Hospital, Tokyo Dental College)
  • Received : 2022.03.29
  • Accepted : 2022.06.30
  • Published : 2023.03.15
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Abstract

Diaphragmatic reconstruction is required for extensive diaphragmatic defects associated with tumor resection. Methods using artificial mesh and autologous tissues, such as pedicled flaps, have been reported predominantly for diaphragmatic reconstruction. We present the case of a 61-year-old woman who presented with a 14×13×12 cm tumor in the abdominal cavity of the upper left abdomen on computed tomography. The diaphragm defect measuring 12×7 cm that occurred during excision of the malignant tumor was reconstructed using the rectus abdominis muscle and fascial flap. The flap has vertical and horizontal vascular axes; therefore, blood flow is stable. It also has the advantage of increasing the range of motion and reducing twisting of the vascular pedicles. Fascial flap does not require processing such as thinning and can be used during suture fixation. This procedure, which has rarely been reported so far, has many advantages and may be a useful option for diaphragm reconstruction.

Keywords

Acknowledgement

We gratefully acknowledge the work of past and present members of the Department of Surgery at Ichikawa General Hospital. We would also like to thank the members of Editage for English editing and proofreading services.

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