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microvascular free tissue

Roser Pinyol, Robert Montal, Laia Bassaganyas, Daniela Sia, Tadatoshi Takayama, Gar-Yang Chau, Vincenzo Mazzaferro, Sasan Roayaie, Han Chu Lee, Norihiro Kokudo, Zhongyang Zhang, Sara Torrecilla, Agrin Moeini, Leonardo Rodriguez-Carunchio, Edward Gane, Chris Verslype, Adina Emilia Croitoru, Umberto Cillo, Manuel de la Mata, Luigi Lupo, Simone Strasser, Joong-Won Park, Jordi Camps, Manel Solé, Swan N Thung, Augusto Villanueva, Carol Pena, Gerold Meinhardt, Jordi Bruix, Josep M Llovet
OBJECTIVE: Sorafenib is the standard systemic therapy for advanced hepatocellular carcinoma (HCC). Survival benefits of resection/local ablation for early HCC are compromised by 70% 5-year recurrence rates. The phase 3 STORM trial comparing sorafenib with placebo as adjuvant treatment did not achieve its primary endpoint of improving recurrence-free survival (RFS). The biomarker companion study BIOSTORM aims to define (A) predictors of recurrence prevention with sorafenib and (B) prognostic factors with B level of evidence...
August 14, 2018: Gut
Hao Zheng, Yuan Yang, Chen Ye, Peng-Peng Li, Zhen-Guang Wang, Hao Xing, Hao Ren, Wei-Ping Zhou
Lysosomal associated membrane protein 2 (Lamp2) influences a broad range of physiological and pathological processes. However, little is known about the role of Lamp2 in hepatocellular carcinoma (HCC) metastasis. This study found that Lamp2 expression was significantly lower in HCC tissues than in adjacent nontumor tissues (ANTs), and its expression level correlated with HCC metastasis. Low Lamp2 expression was significantly correlated with the AFP serum level (> 20 ng/Ml, P = 0.024), capsular formation (absent, P = 0...
July 13, 2018: Oncotarget
Jocelyn Lu, Michael V DeFazio, Chrisovalantis Lakhiani, Michel Abboud, Morgan Penzler, Tammer Elmarsafi, Paul J Kim, Christopher E Attinger, Karen K Evans
BACKGROUND:  Recent evidence documenting high success rates following microvascular diabetic foot reconstruction has led to a paradigm shift in favor of more aggressive limb preservation. The primary aim of this study was to examine reconstructive and functional outcomes in patients who underwent free tissue transfer (FTT) for recalcitrant diabetic foot ulcers (DFUs) at our tertiary referral center for advanced limb salvage. METHODS:  Between June 2013 and June 2016, 29 patients underwent lower extremity FTT for diabetic foot reconstruction by the senior author (K...
August 12, 2018: Journal of Reconstructive Microsurgery
Mark K Wax, James Azzi
Given the high stakes for microvascular reconstruction, the majority of reconstructive surgeons have developed paradigms for pre, intra, and postoperative management that have proven to result in individual high success rates. Much has been done to identify and avoid perioperative factors that could potentially increase flap failure rates. Two example of this practice has been the generalized use of anticoagulation in free tissue transfer and the prohibition against vasopressor use in patients that are undergoing free tissue transfer...
August 2018: Oral Oncology
Samuel Helman, Sameep Kadakia, Ashley Guthrie, Moustafa Mourad, Grigoriy Mashkevich
Nasoseptal perforations can be a challenging defect for the reconstructive surgeon, with repair limited by the surrounding tissue availability and the defect size. In patients with a history of cocaine use, often the integrity of surrounding vasculature is questionable and large defects may not be well suited for local reconstruction. In the otolaryngology literature, several reconstructive options using local tissue and synthetic materials have been described, but there have been no reports of microvascular free flaps utilized in this regard...
September 2018: Craniomaxillofacial Trauma & Reconstruction
M Jun, S Pušica, V Kojovic, M Bizic, B Stojanovic, Z Krstic, G Korac, M L Djordjevic
OBJECTIVE: To present our technique of musculocutaneous latissimus dorsi (MLD) free-flap total phalloplasty. This technically demanding female-to-male gender reassignment surgery consists of creating a neophallus from extragenital tissue. METHODS: The presented technique included: removal of internal/external female genitalia, creation of neophallus using latissimus dorsi free flap, clitoral incorporation into the neophallus, urethral lengthening and insertion of testicular implants into the newly created scrotum...
August 2, 2018: Urology
T Mücke, C Wolff, A M Fichter, M von Düring, A Kanatas, L M Ritschl
Atherosclerosis is a systemic condition that is responsible for many diseases, and becomes a problem in cases where plaques form at several sites. The formation of a thrombotic embolus may jeopardise vascular operations, including microvascular anastomoses in replantation procedures or free tissue transfers. A mobile imaging tool for the detection of thrombosis preoperatively or intraoperatively would be valuable. An intimal injury, simulating removal of atherosclerotic plaques, was made microsurgically in 60 rat aortas, and results were analysed macroscopically, histologically, and with intraoperative indocyanine green (ICG) videoangiography immediately postoperatively...
July 30, 2018: British Journal of Oral & Maxillofacial Surgery
Miguel de la Parra Marquez, Ricardo Fernandez-Riera
Currently, deep inferior epigastric perforator flap is undoubtedly the first choice for autologous breast reconstruction for most surgeons; however, there are instances where lower abdominal tissue is unavailable for microvascular transfer. In these cases, most surgeons choose gluteal or lower-extremity territories as donor sites.In the setting of morbid obesity, there is an increased risk of flap and donor site complications, as well as increased blood loss, surgical time, and risk of deep venous thrombosis, not to mention a more challenging surgical technique...
July 31, 2018: Annals of Plastic Surgery
Elliot Morse, Cara Henderson, Tracy Carafeno, Jacqueline Dibble, Peter Longley, Edwin Chan, Benjamin Judson, Wendell G Yarbrough, Clarence Sasaki, Saral Mehra
Objective To design and implement a postoperative clinical care pathway designed to reduce intensive care usage on length of stay, readmission rates, and surgical complications in head and neck free flap patients. Methods A postoperative clinical care pathway detailing timelines for patient care was developed by a multispecialty team. In total, 108 matched patients receiving free tissue transfer for reconstruction of head and neck defects in the year before (prepathway), year after (early pathway), and second year after (late pathway) pathway implementation were compared based on postoperative length of stay, 30-day readmission rate, intensive care unit (ICU) admission, and rates of medical/surgical complications...
July 31, 2018: Otolaryngology—Head and Neck Surgery
Mitchell L Worley, Travis M Patterson, Evan M Graboyes, Yongren Wu, Robert M Brody, Joshua Hornig, Zeke Walton
Importance: The chimeric anterolateral thigh osteomyocutaneous (ALTO) free flap is a recently described microvascular option for head and neck osseous defects associated with complex soft-tissue requirements. To date, the association of ALTO flap harvest with femur structural integrity and the need for routine prophylactic fixation following harvest has been incompletely described. Objective: To investigate the association of ALTO flap harvest, with and without prophylactic fixation, on femur structural integrity as measured by 4-point bend and torsional biomechanical testing...
July 26, 2018: JAMA Otolaryngology—Head & Neck Surgery
Georgi Atanasov, Charlotte Pötner, Gabriela Aust, Katrin Schierle, Corinna Dietel, Christian Benzing, Felix Krenzien, Michael Bartels, Uwe Eichfeld, Moritz Schmelzle, Marcus Bahra, Andreas Pascher, Georg Wiltberger
Introduction: M2-polarized tumor-associated macrophages (TAMs) and TIE2-expressing monocytes (TEMs) are associated with angiogenesis and have been identified as a potential prognostic marker in several solid tumors, including hepatobiliary malignancies. However, little is known regarding their influence on tumor progression and patient survival in pancreatic ductal adenocarcinoma (PDAC). Results: Patients with tumors characterized by the presence of CD163+ TAMs or TEMs in TCA or TIF, respectively, showed a significantly decreased 1-, 3- and 5-year overall and recurrence-free survival compared to patients without CD163+ TAMs or TEMs (all ρ < 0...
July 3, 2018: Oncotarget
Altuğ Altınkaya, Şükrü Yazar, İbrahim Sağlam, Kaan Gideroğlu
BACKGROUND: Extensive scalp defects caused by various etiologies often require free-tissue transfer. We aimed to review our experience in the reconstruction of extensive scalp defects with free anterolateral flaps. METHODS: A retrospective analysis was performed on all patients with extensive scalp defects that were reconstructed with free anterolateral thigh flaps from November 2007 to April 2015. Eleven patients with a mean age of 44 years were included in this study...
July 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Patrik Pipkorn, Kelsey Rosenquist, Joseph Zenga
PURPOSE OF REVIEW: The treatment of oral cavity cancer may impair speech and swallowing function. Optimizing posttreatment function may lead to significant improvement of quality of life. RECENT FINDINGS: Although oncologic control remains the main goal of treatment for oral cavity cancer, posttreatment function for surviving patients has over the last decades been recognized as an important secondary outcome. Reconstruction of oral cavity defects range from primary closure to advanced microvascular reconstruction, including multiple tissue types...
July 17, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Limor Raz, Kiran Bhaskar, John Weaver, Sandro Marini, Quanguang Zhang, Jeffery F Thompson, Candice Espinoza, Sulaiman Iqbal, Nicole M Maphis, Lea Weston, Laurel O Sillerud, Arvind Caprihan, John C Pesko, Erik B Erhardt, Gary A Rosenberg
BACKGROUND: Hypertension-induced microvascular brain injury is a major vascular contributor to cognitive impairment and dementia. We hypothesized that chronic hypoxia promotes the hyperphosphorylation of tau and cell death in an accelerated spontaneously hypertensive stroke prone rat model of vascular cognitive impairment. METHODS: Hypertensive male rats (n = 13) were fed a high salt, low protein Japanese permissive diet and were compared to Wistar Kyoto control rats (n = 5)...
July 25, 2018: Neurobiology of Disease
Silvia Gandolfi, Isabelle Auquit-Auckbur, Yoann Poirot, Albane Bonmarchand, Jordane Mouton, Raphael Carloni, Iad Nseir, Fabrice Duparc
INTRODUCTION: The elbow joint is particularly exposed to soft tissue injuries associated with fractures and dislocations. Different coverage options within the past decades for recovering loss of soft tissue defects around the elbow region have been proposed based on anatomical research. Our aim was to make an updated focus on the anatomical basis of different techniques of coverage of loss of tissues around the elbow. MATERIALS AND METHODS: The main procedures of flaps were defined: local random, axial fasciocutaneous, local muscle pedicle, propeller and free microvascular flaps...
July 10, 2018: Surgical and Radiologic Anatomy: SRA
Dominic Henn, Masood Abu-Halima, Florian Falkner, Dominik Wermke, Lilian G Meme, Clemens Kühner, Andreas Keller, Ulrich Kneser, Eckart Meese, Volker J Schmidt
BACKGROUND: The placement of arteriovenous (AV) loops can enable microvascular anastomoses of free flaps when recipient vessels are scarce. In animal models, elevated fluid shear stress in AV loops promotes neoangiogenesis. Anecdotal reports in patients indicate that vein grafts used in free flap reconstructions of ischemic lower extremities are able to induce capillary formation. However, flow-stimulated angiogenesis has never been systematically investigated in humans and it is unclear whether shear stress alters proangiogenic signaling pathways within the vascular wall of human AV loops...
July 2, 2018: Plastic and Reconstructive Surgery
Lee W T Alkureishi, Chad A Purnell, Patricia Park, Bruce S Bauer, Neil A Fine, Mark Sisco
INTRODUCTION: Whereas free tissue transfer has evolved to minimize morbidity in adults, less is known about outcomes after free flaps in children. This study sought to assess short- and long-term outcomes after microvascular reconstruction in the pediatric population. METHODS: Short- and long-term outcomes of free tissue transfer were assessed using chart-review and quality-of-life surveys. The Pediatric Outcomes Data Collection Instrument was used to evaluate overall health, pain, and ability to participate in normal daily and more vigorous activities...
July 2, 2018: Annals of Plastic Surgery
Alberto Ruiz-Cases, Enrique Salmerón-González, Alberto Pérez-García, Juan R Esteban-Vico, Elena García-Vilariño
No abstract text is available yet for this article.
June 22, 2018: Plastic and Reconstructive Surgery
Summer E Hanson, Patrick B Garvey
No abstract text is available yet for this article.
June 22, 2018: Plastic and Reconstructive Surgery
Amir Inbal, Amanda K Silva, Laura S Humphries, Chad M Teven, Lawrence J Gottlieb
BACKGROUND: Successful free tissue transfer requires tension-free microvascular anastomoses. Vein grafts are utilized when this cannot be obtained, which increases microsurgical complexity and the chance of vessel thrombosis. Previous studies on vein grafts are limited to low numbers and selected techniques, making it difficult to draw conclusions. METHODS: A retrospective chart review was performed for all patients who underwent vein grafts in free flap reconstruction from 1995 to 2015...
June 22, 2018: Plastic and Reconstructive Surgery
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