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- Title
A hundred patients with vertical rectus abdominis myocutaneous (VRAM) flap for pelvic reconstruction after total pelvic exenteration.
- Authors
Horch, R.; Hohenberger, W.; Eweida, A.; Kneser, U.; Weber, K.; Arkudas, A.; Merkel, S.; Göhl, J.; Beier, J.
- Abstract
Purpose: We analysed the outcomes of a series of 100 consecutive patients with anorectal cancer with neoadjuvant radiochemotherapy and abdominoperineal exstirpation or total pelvic exenteration, who received a transpelvic vertical rectus abdominis myocutaneous (VRAM) flap for pelvic, vaginal and/or perineal reconstruction and compare a cohort to patients without VRAM flaps. Methods: Within a 10-year period (2003-2013) in our institution 924 patients with rectal cancer stage y0 to y IV were surgically treated. Data of those 100 consecutive patients who received a transpelvic VRAM flap were collected and compared to patients without flaps. Results: In 100 consecutive patients with transpelvic VRAM flaps, major donor site complications occurred in 6 %, VRAM-specific perineal wound complications were observed in 11 % of the patients and overall 30-day mortality was 2 %. Conclusions: The VRAM flap is a reliable and safe method for pelvic reconstruction in patients with advanced disease requiring pelvic exenteration and irradiation, with a relatively low rate of donor and recipient site complications. In this first study, to compare a large number of patients with VRAM flap reconstruction to patients without pelvic VRAM flap reconstruction, a clear advantage of simultaneous pelvic reconstruction is demonstrated.
- Subjects
RECTUS abdominis muscles; CANCER patients; SURGICAL flaps; CANCER complications; PELVIC exenteration; PELVIC surgery
- Publication
International Journal of Colorectal Disease, 2014, Vol 29, Issue 7, p813
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-014-1868-0