[What is the advantage of free microvascular tissue transfer after pelvic exenteration? A argument for delayed primary management].
Locoregional pelvic recurrences are amenable to re-resection even if musculoskeletal fixation is present. This report updates our experience with pelvic composite resections and microsurgical closure of the perineal cavity by nine latissimus dorsi flaps, one as a bilobed type combined with a scapula flap. All flaps survived. There was one rupture of the vascular pedicle following repositioning of the patient. Another flap healed completely, but presented a wound rupture with secondary healing in the area of the rima ani. Three major advantages to this method have been proven: (1) Healing and hospitalization could be reduced compared to conservative treatment; (2) The latissimus dorsi transfer allows stable perineal coverage and closure of dead space, preventing any pelvic herniation; (3) Performed as a delayed procedure the free tissue transfer is well tolerated by the patient.
Brenner
P
P
Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover.
Reichert
B
B
Raab
R
R
Berger
A
A
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010348:Patient Care Team; D010385:Pelvic Exenteration / Q000379:methods*; D010386:Pelvic Neoplasms / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps / Q000379:methods*
Was leistet der freie mikrovaskuläre Gewebetransfer nach einer Exenteratio pelvis? Ein Plädoyer für die aufgeschobene Primärversorgung.