Open Access
CC BY 4.0 · Arch Plast Surg 2023; 50(02): 166-170
DOI: 10.1055/a-1938-0763
Breast/Trunk
Case Report

Reconstruction of Extensive Diaphragmatic Defects Using the Rectus Abdominis Muscle and Fascial Flap

Shumpei Kato 
1   Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan
,
Hisashi Sakuma 
1   Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan
,
Takako Fujii 
1   Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan
,
Ichiro Tanaka 
1   Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan
,
Junichi Matsui 
2   Department of Surgery, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan
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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

diaphragm - rectus abdominis muscle - fascial flap - reconstruction - case report

Author Contributions

Conceptualization: S.K.; Data curation: H.S.; Formal analysis: S.K.; Funding acquisition: I.T.; Methodology: S.K., H.S., T.F., J.M., I.T.; Project administration: S.K.; Visualization: S.K., I.T.; Writing -original draft: S. K; Writing -review and editing: H.S.


Ethical Approval

This study was performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from the patient.


Patient Consent

The patient provided written informed consent for publication and use of her images.




Publication History

Received: 29 March 2022

Accepted: 30 June 2022

Accepted Manuscript online:
07 September 2022

Article published online:
01 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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