Application of Rotational Computed Tomography Angiography and 3D Modeling in Planning One-Stage Reconstruction of the Pelvic Floor after Evisceration of the Pelvic Organs
The aim of the investigation was to improve perineum plasty method by evaluating the properties of a skin-muscle-fascia flap of the thin thigh muscle (gracilis muscle) using rotational computed tomography angiography and 3D modeling in patients with locally advanced primary or recurrent malignant tumors of the pelvic organs. Materials and methods. Transradial access using Innova 3131 IQ angiographic unit (General Electric, USA) was used in the work. A survey dynamic angiography of the abdominal aorta and the lower limb arteries was carried out in order to obtain images of blood vessels and assess the character of blood flow. If atherosclerotic lesions of the iliac or femoral artery segment were detected, stenting or balloon angioplasty was performed. Results. rotational computed tomography angiography with 3D modeling in the preoperative period allow the surgeons to obtain information on vascular anatomy of gracilis muscle in patients planned to undergo reconstructive plasty of the perineum by a skin-muscle-fascial flap of the gracilis muscle. This makes it possible to perform one-stage plastic operation with the best composite flap design selected and to correct the damaged lower extremity arteries without open surgery, if they are detected.