A novel technique for surgical reconstruction of the perineal floor following anteroposterior exenteration of the pelvis--case report and review of the literature.
Pelvic exenteration is the only potentially curative surgical procedure for patients with recurrent cervical, vaginal, vulvar or rectal cancers, especially following adjuvant chemotherapy or radiotherapy. Morbidity rates, however, remain high, which is significantly attributed to complications of the pelvic floor reconstruction techniques. We describe a novel reconstruction technique of the pelvic floor, involving a combination of an oblique rectus abdominis myocutaneous flap and a synthetic absorbable mesh as a pelvic sling for additional support, in a 63-year-old female patient with recurrent vulvar carcinoma. Combining the use of myocutaneous flaps and prosthetic mesh material can provide an effective alternative solution to the complications arising from pelvic floor reconstruction of large defects after exenteration procedures, especially in previously irradiated settings. Further studies are necessary to define the long-term outcomes and indications of these techniques, as well as the optimal combination between the available myocutaneous flaps and prosthetic materials.
2nd Department of Surgery, Areteion Hospital, University of Athens Medical School, Greece. mkyriazi@otenet.gr
M A
MA
Kyriazi
V K
VK
Stafyla
A
A
Kondi-Pafiti
N
N
Arkadopoulos
N
N
Dafnios
D
D
Hasiakos
S
S
Fotiou
D
D
Mastorakos
V
V
Smyrniotis
D002277:Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010385:Pelvic Exenteration / Q000379:methods*; D010388:Pelvis / Q000601:surgery; D019919:Prosthesis Implantation / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D053825:Suburethral Slings; D013524:Surgical Flaps; D013526:Surgical Mesh; D014846:Vulvar Neoplasms / Q000601:surgery*