Reconstruction of a pelvic floor defect using a pedicled tensor fascia lata flap: a new technique to prevent radiation injury for pediatric patients with advanced pelvic tumors.
BACKGROUND
In the treatment of pelvic tumors, pelvic floor defects owing to a wide excision tend to increase the occurrence of such morbidities as radiation injury. The reconstruction of these defects would minimize the risk of such morbidities. Authors introduce a new technique for repairing a pelvic floor defect using a tensor fascia lata flap.


METHODS
Two boys, 4 years old and 10 months old, presenting with pelvic rhabdomyosarcoma underwent a tumor extirpation associated with a wide excision of the pelvic organs. After the removal of the tumor, a tensor fascia lata flap was designed on the right thigh. The pedicled rotation flap was subcutaneously elevated, guided to the intraperitoneal cavity, and was fixed to cover the superior aperture of the lesser pelvis.


RESULTS
The flaps functioned well, and postoperative radiation therapies consisting of 45 and 41.4 Gy to the lesser pelvic cavity were carried out without any complications. As a result, the necessary postoperative protocol combination therapies could be successfully performed in a timely manner.


CONCLUSIONS
The pedicled tensor fascia lata flap is considered to be an alternative option for the stable repair of pelvic floor defects to prevent radiation injury.
Ohno
Yasuharu
Y
Division of Pediatric Surgery, Department of Surgery, Nagasaki University Graduate School of Medical Sciences, Nagasaki 852-8501, Japan. ohno_y@saitama-med.ac.jp
Tanaka
Katsumi
K
Kanematsu
Takashi
T
Noguchi
Mitsuru
M
Okada
Masahiko
M
Kamitamari
Akira
A
Hayashi
Nobuyuki
N
D017024:Chemotherapy, Adjuvant; D005206:Fascia Lata / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D017773:Pelvic Floor / Q000601:surgery; D010386:Pelvic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D019651:Plastic Surgery Procedures; D012208:Rhabdomyosarcoma / Q000532:radiotherapy* / Q000601:surgery*; D013524:Surgical Flaps; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery