病例报告：数字CTA辅助股前外侧穿支蒂皮瓣修复外阴Paget病术后缺损
Case Report: Digital CTA-assisted anterolateral thigh perforator pedicled flap for repairing postoperative defects in Vulvar Paget's disease.
摘要(中文译文)
外阴佩吉特病（VPD）常需广泛切除，可能导致会阴组织缺损。股前外侧（ALT）皮瓣是常用的重建选择；然而，其穿支血管的解剖变异可能带来手术挑战。本研究旨在评估术前数字计算机断层血管造影（CTA）在ALT皮瓣规划中的作用，并报告我们在外阴佩吉特病切除术后外阴重建中的经验。回顾性分析了一例外阴佩吉特病患者的临床资料。在广泛局部切除后，计划使用ALT皮瓣进行外阴重建。术前行CTA联合三维（3D）数字重建技术，以定位和评估股前外侧穿支血管，指导个性化皮瓣设计。按照术前计划切取并转移皮瓣，以重建外阴缺损。数字CTA成功描绘了穿支血管的起源、走行和管径，有助于安全、精确地切取皮瓣。术后皮瓣灌注良好，外阴形态和功能恢复满意。供区愈合顺利。术前CTA能有效评估ALT皮瓣的穿支解剖，提高手术的可预测性和安全性。它是外阴佩吉特病切除术后外阴重建中有价值的辅助手段。
Abstract
Vulvar Paget's disease (VPD) often requires extensive resection that may result in perineal tissue defects. The anterolateral thigh (ALT) flap is a commonly used reconstructive option; however, anatomical variations in its perforator vessels can pose surgical challenges. This study aims to evaluate the role of preoperative digital computed tomographic angiography (CTA) in ALT flap planning and to report our experience with vulvar reconstruction following Vulvar Paget's disease excision. Clinical data from a patient with Vulvar Paget's disease were retrospectively analyzed. Following wide local excision, vulvar reconstruction using an ALT flap was planned. Preoperative CTA combined with three-dimensional (3D) digital reconstruction technology was performed to localize and assess the perforator vessels of the anterolateral thigh, guiding the design of a customized flap. The flap was harvested and transferred according to the preoperative plan to reconstruct the vulvar defect. Digital CTA successfully delineated the origin, course, and caliber of the perforator vessels, facilitating safe and precise flap harvest. Postoperatively, the flap demonstrated good perfusion, with satisfactory vulvar morphology and functional recovery. The donor site healed uneventfully. Preoperative CTA effectively assesses the perforator anatomy of the ALT flap, enhancing surgical predictability and safety. It serves as a valuable adjunct in vulvar reconstruction following Vulvar Paget's disease excision.
如何引用
AMA
Yawen Bai, Yifan He, Ping Tang, Zesheng Zeng, Wei Wang, Haoming Luo, et al. Case Report: Digital CTA-assisted anterolateral thigh perforator pedicled flap for repairing postoperative defects in Vulvar Paget's disease.. Frontiers in medicine. 2026; doi:10.3389/fmed.2026.1835423.
APA
Yawen Bai, Yifan He, Ping Tang, Zesheng Zeng, Wei Wang, Haoming Luo, et al (2026). Case Report: Digital CTA-assisted anterolateral thigh perforator pedicled flap for repairing postoperative defects in Vulvar Paget's disease.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1835423
GB/T 7714
Yawen Bai, Yifan He, Ping Tang, Zesheng Zeng, Wei Wang, Haoming Luo, et al. Case Report: Digital CTA-assisted anterolateral thigh perforator pedicled flap for repairing postoperative defects in Vulvar Paget's disease.[J]. Frontiers in medicine, 2026 doi:10.3389/fmed.2026.1835423.
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