title: Modified gluteus maximus V-Y advancement flap for reconstruction of perineal defects after resection of intrapelvic recurrent rectal cancer: report of a case.
abstract: Technical advances in myocutaneous flap preparation have resulted in primary reconstruction now being generally indicated for malignant tumors extensively infiltrating the pelvic cavity and perineum. Pelvic tumor resection can dramatically improve the health-related quality of life (QOL) of patients with locally recurrent rectal cancer complicated by infection and pain. However, the removal of a wide area of perineum by these two procedures often leaves a large dead space. A gluteal thigh muscle, rectus abdominis muscle, or pedicle myocutaneous flap is usually made to reconstruct such extensive perineal defects. The subject of this case report was a 76-year-old woman with recurrent rectal cancer in the pelvis after abdominoperineal resection. The large pelvic tumor, which was causing severe pain, was resected and the extensive perineal defects were reconstructed using a modified maximus V-Y advancement flap. The operating time was approximately 30 min, and the pain after surgery was much less severe. Moreover, she could walk the day after surgery and returned to normal daily life without requiring prolonged bed rest. No infection developed in the intrapelvic dead space postoperatively. This technique proved very useful for improving the patient's QOL.
authors.affiliation: First Department of Surgery, Fukui Medical University, Fukui, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Goi
authors.forename: Kenji
authors.initials: K
authors.lastname: Koneri
authors.forename: Kanji
authors.initials: K
authors.lastname: Katayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hirose
authors.forename: Osamu
authors.initials: O
authors.lastname: Takashima
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Mizutani
authors.forename: Hosatoshi
authors.initials: H
authors.lastname: Baba
authors.forename: Akio
authors.initials: A
authors.lastname: Yamaguchi
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000601:surgery; D010502:Perineum / Q000601:surgery*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D013524:Surgical Flaps