Main morphological characteristics of the vascular pedicle of latissimus dorsi muscle and their relevance in operative treatment

Abstract

Introduction. Considering operative treatment of various pathological conditions and traumatic injuries of extremities latissimus dorsi flap presents the most frequently used flap in reconstructive surgery. Objective. The aim of this paper was to analyze anatomical characteristics of the vascular pedicle of the latissimus dorsi muscle followed by morphometric analyzes of vascular elements. Methods. This paper was carried out in cooperation with the Institute of Anatomy of the School of Medicine, University of Belgrade. The study was based on 40 cadaver dissections followed by anatomical and morphometric analyzes. The first analysis included the determination of thoracodorsal artery (TDA) origin and its lateral and terminal branches, and the second one the observation of artery path. Furthermore the same features were analyzed on the thoracodorsal vein. During morphometric analyzes artery and vein length and diameter were recorded. Results. Our results showed that TDA always contains one lateral branch, while three other lateral branches were inconstant. In most cases TDA terminated in two branches, upper and lower, with average distance of 3.4 cm from the muscle. The mean recorded pedicle length was 9.9 cm. The average inner diameter of TDA was 1.85 mm. In further analyses the average observed thoracodorsal vein length was 10.5 cm with mean diameter of 2.93 mm. The result showed that vein origin was usually represented with two branches. Conclusion. The thoracodorsal artery is a blood vessel of considerable length and diameter which represents a great advantage in reconstructive flap surgery.