Comparison of the Complications in Vertical Rectus Abdominis Musculocutaneous Flap with Non-Reconstructed Cases after Pelvic Exenteration.
10.5999/aps.2014.41.6.722
- Author:
Heechang JEON
1
;
Eul Sik YOON
;
Hi Jin YOU
;
Hyon Surk KIM
;
Byung Il LEE
;
Seung Ha PARK
Author Information
1. Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. yesanam2@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Pelvic exenteration;
Rectus abdominis;
Musculocutaneous flap
- MeSH:
Cicatrix;
Humans;
Myocutaneous Flap*;
Pelvic Exenteration*;
Peritonitis;
Rectus Abdominis*;
Retrospective Studies;
Surgery, Plastic;
Wound Infection
- From:Archives of Plastic Surgery
2014;41(6):722-727
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Perineal reconstruction following pelvic exenteration is a challenging area in plastic surgery. Its advantages include preventing complications by obliterating the pelvic dead space and minimizing the scar by using the previous abdominal incision and a vertical rectus abdominis musculocutaneous (VRAM) flap. However, only a few studies have compared the complications and the outcomes following pelvic exenteration between cases with and without a VRAM flap. In this study, we aimed to compare the complications and the outcomes following pelvic exenteration with or without VRAM flap coverage. METHODS: We retrospectively reviewed the cases of nine patients for whom transpelvic VRAM flaps were created following pelvic exenteration due to pelvic malignancy. The complications and outcomes in these patients were compared with those of another nine patients who did not undergo such reconstruction. RESULTS: Flap reconstruction was successful in eight cases, with minor complications such as wound infection and dehiscence. In all cases in the reconstructed group (n=9), structural integrity was maintained and major complications including bowel obstruction and infection were prevented by obliterating the pelvic dead space. In contrast, in the control group (n=9), peritonitis and bowel obstruction occurred in 1 case (11%). CONCLUSIONS: Despite the possibility of flap failure and minor complications, a VRAM flap can result in adequate perineal reconstruction to prevent major complications of pelvic exenteration.
