title: Transpelvic rectus abdominis flap reconstruction of defects following abdominal-perineal resection.
abstract: Abdominal-perineal resection for advanced rectal carcinoma may leave a large defect for which complete secondary healing can be slow. In such cases, the inferiorly based rectus abdominis myocutaneous flap, passed through the pelvis into the perineum, can provide a large amount of well-vascularized tissue that may be placed in the defect to facilitate primary healing and allow a quicker recovery. Additional advantages include displacement of the bowel out of the pelvis to facilitate postoperative radiotherapy, and the ability to reconstruct vaginal wall defects. We report a series of seven patients for whom the transpelvic rectus abdominis myocutaneous flap was used to cover perineal defects following abdominal-perineal resection. Although one flap failed, all patients healed rapidly and the only lasting complication was a possibly related small upper-abdominal hernia found one year after surgery.
authors.affiliation: Section of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston.
authors.forename: S S
authors.initials: SS
authors.lastname: Kroll
authors.forename: R
authors.initials: R
authors.lastname: Pollock
authors.forename: J M
authors.initials: JM
authors.lastname: Jessup
authors.forename: D
authors.initials: D
authors.lastname: Ota
mesh_terms: D000009:Abdominal Muscles / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods*