Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Comparison of the Complications in Vertical Rectus Abdominis Musculocutaneous Flap with Non-Reconstructed Cases after Pelvic Exenteration

  • Jeon, Heechang (Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Yoon, Eul Sik (Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • You, Hi-Jin (Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Kim, Hyon-Surk (Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Lee, Byung-Il (Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Park, Seung Ha (Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine)
  • Received : 2014.05.08
  • Accepted : 2014.07.10
  • Published : 2014.11.15
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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.

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References

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  1. Local Recurrence after Abdominoperineal Resection with Vertical Rectus Abdominis Musculocutaneous Flap:A Case Report of Pelvic Exenteration with Preservation of the Flap vol.75, pp.1, 2014, https://doi.org/10.3862/jcoloproctology.75.15