Reconstruction with Vertical Rectus Abdominus Myocutaneous flap in advanced pelvic malignancy

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• 作者：Terrence A. Creagh^a ; ^{tcreagh@xtra.co.nz} ; Liane Dixon^b ; Frank A. Frizelle^b
• 关键词：Vertical Rectus Abdominus Myocutaneous flap (VRAM) ; Pelvic exenteration ; Advanced pelvic cancer ; Neo-adjuvant chemotherapy ; Neo-pelvic diaphragm
• 刊名：Journal of Plastic ; Reconstructive Aesthetic Surgery
• 出版年：2012
• 期刊代码：193_17486815
• 类别：med
• 出版时间：June, 2012
• 卷：65
• 期：6
• 页码：791-797
• 文件大小：839 K

摘要

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Summary

Pelvic extenuative surgery produces good long term outcomes in advanced pelvic malignancies. We evaluate the use and clinical outcomes of the Vertical Rectus Abdominus Myocutaenous (VRAM) flap as a reconstruction technique in a heterogenic cohort of patients with advanced colorectal cancer in whom neo-adjuvant chemo-radiotherapy had been performed pre-operatively.

Analysis of patients having VRAM flaps for pelvic reconstruction in a tertiary referral centre from 2001 to 2010 was conducted. 37 patients (23 female, 14 male) underwent pelvic extenuative surgery of which 22 (60%) had recurrent pelvic disease. All surgical and medical complications were analysed. Major flap complications were defined as 鈥榬equiring return to the operating theatre at any stage鈥?and these occurred in 6 (16%) patients. There were 7 (19%) minor flap complications defined as 鈥榬equiring conservative non surgical treatment鈥?The total global re-intervention rate of patients requiring return to theatre for re-operation as a result of their exenteration and reconstruction was 6 (16%).

We highlight the merits and versatility of the VRAM flap in advanced pelvic malignancy in obtaining stable and supple reconstructive cover and the relative low morbidity in this difficult group confirms out strong support for immediate VRAM reconstruction in pelvic exenterative procedures.