Arterial blood supply of the umbilical region in newborns

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Abstract

The review of national and foreign literature sources presents information on arterial blood supply of the umbilical region in newborns having relevant practical significance due to the development of new surgical approaches in that part of the anterior abdominal wall. Scientific data on the course and location of arteries participating in the blood supply of the umbilical region are summarized. Particular attention is devoted to the description of superficial, superior and inferior epigastric arteries and umbilical arteries. The issues of intervascular connections between the named arteries and other blood vessels are discussed including information on various anastomosis variations and their extent. Various existing viewpoints regarding the location and depth of anastomoses between the vessels essential for blood supply of the umbilical region are presented as well as the layers, through which the main arteries pass, and the character and level of their branching. Features of arterial blood supply of the umbilical region in newborns are also noted. The paper contains data on the role of umbilical arteries in the umbilical region supply in children of that age. It is demonstrated that blood supply of the umbilical region in newborns still poses issues that are insufficiently researched and solved, such as assessing functional capacity of the umbilical arteries, revealing histotopographic peculiarities in the location of blood vessels within the layers and various segments of the umbilical region, topographic and anatomic identification of the segments that are most and least supplied with arterial vessels in that part of the abdominal wall.

About the authors

A N Kivva

Rostov State Medical University

Author for correspondence.
Email: kivva@aaanet.ru
Rostov-on-Don, Russia

A V Leiga

City Hospital №20

Email: kivva@aaanet.ru
Rostov-on-Don, Russia

References

  1. Kozlov Yu.A., Novozhilov V.A., Podkamenev A.V. et al. The use of paraumbilical approach in surgical treatment of duodenal atresia. Detskaya khirurgiya. 2013; (2): 18–21. (In Russ.)
  2. Chepurnoy G.I., Kivva A.N., Katsupeev V.B. et al. A method for semicircular periumbilical access in newborns and infants. Patent for invention RF №2633289. Bulletin issued on 11.10.2017. (In Russ.)
  3. Vorob'ev A.A., Tarba A.A., Mikhin I.V et al. Algoritmy operativnykh dostupov. (Surgical approach algorithms.) St. Petersburg: ELBI-SPb. 2015; 272 p. (In Russ.)
  4. Skandalakis J., Skandalakis P., Skandalakis L. Surgical anatomy and technique: A pocket manual, 3rd ed. Springer, 2009. 696 p. Russ. Ed.: Skandalakis J., Skandalakis P., Skandalakis L. Operativnaya khirurgiya. Moscow: Praktika. 2009; 704 p. (In Russ.)
  5. Maksimenkov A.N. Khirurgicheskaya anatomiya zhivota. (Abdominal surgical anatomy.) Leningrad: Meditsina. 1972; 664 p. (In Russ.)
  6. Kagan I.I., Kirpatovskiy I.D. Topograficheskaya anatomiya i operativnaya khirurgiya. (Topographic anatomy and operational surgery.) Moscow: GEOTAR-Media. 2013; 1088 p. (In Russ.)
  7. Netter F.H. Atlas of human anatomy. 6th ed. Philadelphia: Elsevier/Saunders. 2014; 640 p. Russ. ed.: Netter F. Atlas anatomii cheloveka. Izd. 6-e. Moscow: GEOTAR-Media. 2017; 624 p. (In Russ.)
  8. Tregaskiss A., Goodwin A., Acland R. The cutaneous arteries of the anterior abdominal wall: a three-dimensional study. Plast. Reconstr. Surg. 2007; 120 (2): 442–450. doi: 10.1097/01.prs.0000267414.66623.6e.
  9. Onishi K., Maruyama Y. Cutaneous and fascial vasculature around the rectus abdominis muscle: anatomic basis of abdominal fasciocutaneous flaps. J. Reconstr. Microsurg. 1986; 2 (4): 247–253. doi: 10.1055/s-2007-1007030.
  10. Nikolaev A.V. Topograficheskaya anatomiya i operativnaya khirurgiya. (Topographic anatomy and operational surgery.) Moscow: GEOTAR-Media. 2015; 736 p. (In Russ.)
  11. Saber A., Meslemani A., Davis R. Safety zones for anterior abdominal wall entry during laparoscopy: a CT scan mapping of epigastric vessels. Ann. Surg. 2004; 239 (2): 182–185. doi: 10.1097/01.sla.0000109151.53296.07.
  12. Chen X., Wang B., Zheng H. et al. Anatomic study and application of TRAM flap with partial preservation of abdominal rectus muscle in the breast reconstruction. Zhonghua Zheng Xing Wai Ke Za Zhi. 2012; 28 (4): 248–252. PMID: 23173417.
  13. O'Dey D., Heimburg D., Prescher A. et al. The arterial vascularisation of the abdominal wall with special regard to the umbilicus. Br. J. Plast. Surg. 2004; 57 (5): 392–397. doi: 10.1016/j.bjps.2004.02.008.
  14. Berdajs D., Turina M.I. Operative anatomy of the heart. Berlin: Springer-Verlag. 2011; 560 р. doi: 10.1007/978-3-540-69229-4.
  15. Boyd J., Taylor G., Corlett R. The vascular territories of the superior epigastric and the deep inferior epigastric systems. Plast. Reconstr. Surg. 1984; 73 (1): 1–16. doi: 10.1097/00006534-198401000-00001.
  16. Moon H., Taylor G. The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep superior epigastric system. Plast. Reconstr. Surg. 1988; 82 (5): 815–832. doi: 10.1097/00006534-198811000-00014.
  17. Margorin E.M. Topografo-anatomicheskie osobennosti novorozhdennogo. (Topographic and anatomic peculiarities of newborns.) Leningrad: Meditsina. 1977; 280 p. (In Russ.)
  18. Sozykin A.A., Kivva A.N., Leiga A.V. Histotopographic peculiarities of the umbilical region in newborns. Sovremennye problemy nauki i obrazovaniya. 2017; (2). http://www.science-education.ru/article/view?id=26155 (access date: 12.01.2018). (In Russ.)
  19. Adamskaya N.A., Kosova I.A. Planning of free low abdominal flaps according to radiodiagnosis methods. Meditsinskaya vizualizatsiya. 2011; (2): 68–72. (In Russ.)
  20. Chernykh A.V., Zakurdaev E.I., Yakusheva N.V. et al. Applied features of inferior epigastric artery variant anatomy. Zhurnal anatomii i gistopatologii. 2016; 5 (4): 74–78. (In Russ.)
  21. El-Mrakby H., Milner R. The vascular anatomy of the lower anterior abdominal wall: a microdissection study on the deep inferior epigastric vessels and the perforator branches. Plast. Reconstr. Surg. 2002; 109 (2): 539–543. doi: 10.1097/00006534-200202000-00020.
  22. Niazi Z., Kutty M., Petro J. et al. Vaginal reconstruction with a rectus abdominis musculoperitoneal flap. Ann. Plast. Surg. 2001; 46 (5): 563–568. doi: 10.1097/00000637-200105000-00017.
  23. Zhang X., Wang S., Fan Q. et al. Thoracoumbilical flap: experience with 33 cases. J. Reconstr. Microsurg. 2004; 20 (2): 133–137. doi: 10.1055/s-в 2004-820768.
  24. Saad A., Rebowe R., Hogan M. et al. Localization of the dominant deep inferior epigastric artery perforator by computed tomography angiogram: does the standard deep inferior epigastric artery perforator flap design include the dominant perforator? Ann. Plast. Surg. 2014; 72 (6): 670–673. doi: 10.1097/SAP.0b013e31826a1897.
  25. Shang Z., Zhao Y., Ding H. et al. Repair of hand scars by a dilated deep inferior epigastric artery perforator flap. J. Plast. Surg. Hand Surg. 2011; 45 (2): 102–108. doi: 10.3109/2000656X.2011.571844.
  26. Phillips T.J., Stella D.L., Rozen W.M. et al. Abdominal wall CT angiography: a detailed account of a newly established preoperative imaging technique. Radiology. 2008; 249 (1): 32–44. doi: 10.1148/radiol.2483072054.
  27. Schmidt M., Tinhofer I., Duscher D. Perforasomes of the upper abdomen: an anatomical study. J. Plast. Reconstr. Aesthet. Surg. 2014; 67 (1): 42–47. doi: 10.1016/j.bjps.2013.08.017.
  28. Koreiba K.A., Ibatullin I.A. Topographoanatomic justification of insertion of troachars in abdominal endoscopic surgery. Kazan medical journal. 2003; 84 (5): 360–362. (In Russ.)
  29. Holm C., Mayr M., Heftier E. et al. The versatility of the SIEA flap: a clinical assessment of the vascular territory of the superficial epigastric inferior artery. J. Plast. Reconstr. Aesthet. Surg. 2007; 60: 946–951. doi: 10.1016/j.bjps.2005.12.066.
  30. Spiegel A.J., Khan F.N. An intraoperative algorithm for use of the SIEA flap for breast reconstruction. Plast. Reconstr. Surg. 2007; 120: 1450–1459. doi: 10.1097/01.prs.0000270282.92038.3f.
  31. Kivva A.N., Shvyrev A.A., Leiga A.V. Arterial capacity in different segments of the umbilical region in newborns. Sovremennye problemy nauki i obrazovaniya. 2016; (6). http://www.science-education.ru/article/view?id=25977 (access date: 14.01.2018). (In Russ.)
  32. Joy P., Prithishkumar I., Isaac B. Clinical anatomy of the inferior epigastric artery with special relevance to invasive procedures of the anterior abdominal wall. J. Minim. Access Surg. 2017; 13 (1): 18–21. doi: 10.4103/0972-9941.181331.
  33. Gençhellaç H., Dursun M., Temizöz O. Two-detector computed tomography map of the inferior epigastric vessels for percutaneous transabdominal intervention procedures. Balkan. Med. J. 2014; 31 (1): 72–76. doi: 10.5152/balkanmedj.2014.13002.
  34. Zatolokina M.A., Kuznetsov S.L., Protsenko E.P. et al. Results of the studying of morphological features of the paranevrium of branches of the brachial plexus in the evolutionary aspects by using mathematical analysis and modeling. Zhurnal anatomii i gistopatologii. 2016; (3): 17–26. (In Russ.)
  35. Sozykin A.A., Kivva A.N., Leiga A.V. et al. Morfologphical features of the structure and blood supply in newborn umbilical region. Meditsinskiy vestnik Yuga Rossii. 2017; 8 (3): 82–85. (In Russ.)
  36. Feneis H., Dauber W. Pocket atlas of human anatomy. 8th ed. Thieme, 2005, 509 p. Russ. ed.: Fenish H. Karmannyy atlas anatomii cheloveka. St. Petersburg: Dilya. 2014; 576 p. (In Russ.)
  37. Tikhonova L.V., Obukhov V.V., Anosova A.S. Clinical aspect of anatomical peculiarities of the umbilical artery during the postnatal period. Vestnik Smolenskoy gosudarstvennoy meditsinskoy akademii. 2003; (5): 122–126. (In Russ.)
  38. Kivva A.N., Leiga A.V., Maeva E.G. Diameter of the umbilical arteries in newborns based on the results of an ultrasound examination. Sovremennye problemy nauki i obrazovaniya. 2017; (1). http://science-education.ru/ru/article/view?id=26071 (access date: 16.01.2018). (In Russ.)
  39. Kivva A.N., Leiga A.V., Maeva Y.G. Blood flow linear velocity in umbilical arteries of newborns based on the results of an ultrasound examination. Sovremennye problemy nauki i obrazovaniya. 2017; (2). https://www.science-education.ru/article/view?id=26280 (access date: 16.01.2018). (In Russ.)

© 2018 Kivva A.N., Leiga A.V.

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