Poster électronique

Performance de l’angioscanner de repérage dans la reconstruction mammaire par lambeau DIEP
J. Soussan, C. Prost, C. Philandrianos, Y. Irani, D. Casanova, M. Panuel - Marseille - France
Congrès 2010
Résumé
Objectifs
La technique de reconstruction mammaire par lambeau perforateur de l'artère épigastrique inférieure profonde consiste à prélever un lambeau cutanéo-graisseux en regard du muscle grand droit. Cette technique microchirurgicale permet de reconstruire un sein souple, chaud et de consistance naturelle en limitant les complications pariétales. Repérer les vaisseaux perforateurs du pédicule épigastrique permet de faciliter la technique chirurgicale en évitant des dissections inutiles et réduit ainsi le temps opératoire.
Matériels et méthodes
Dans notre centre, nous réalisons un angioscanner pré-opératoire afin de repérer ces vaisseaux. Des reconstructions multiplanaires et en rendu de volume sont réalisées. La projection de l'émergence de ces vaisseaux par rapport à l'ombilic renseigne le chirurgien sur la zone d'intérêt. Le scanner permet de donner aussi des renseignements sur le calibre de ces artères. Les patientes bénéficient aussi d’un doppler de repérage dont les résultats sont comparés à ceux du scanner.
Résultats
Les données de l'angioscanner sont comparées à celles du doppler puis aux constatations du chirurgien concernant la topographie et le calibre des artères perforantes. Vingt examens ont été réalisés, les données préliminaires confirment la performance de l'angioscanner pour le repérage et la sélection de la meilleure perforante.
Conclusion
Le DIEP est une technique microchirugicale de reconstruction mammaire limitant les complications des techniques conventionnelles. Le repérage par angioscanner pré-opératoire des artères perforantes est performant et permet de diminuer la durée de l'intervention.
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