title: Reconstruction of total pelvic exenteration defects with rectus abdominus myocutaneous flaps versus primary closure.
abstract: BACKGROUND
  Total pelvic exenteration (TPE) is reserved for patients with locally invasive and recurrent pelvic malignancies. Complications such as wound infections, dehiscence, hernias, abscesses, and fistulas are common after this procedure. The purpose of this study was to determine whether tissue transfer to the pelvis after TPE decreases wound complications.
  
  
  METHODS
  Fifty-three patients who underwent TPE between 2004 and 2010 were reviewed. Two groups were identified, those who underwent pelvic reconstruction with a vertical rectus abdominus myocutaneous flap (n = 17) and those who underwent primary closure (n = 36). Demographics, clinicopathologic characteristics, and outcomes were compared.
  
  
  RESULTS
  The 2 groups were similar in demographics and histopathologic characteristics. Preoperative and surgical factors including comorbidities, nutrition, radiation, surgical times, blood loss, length of stay, and complications were similar between the groups. Of the 17 patients undergoing vertical rectus abdominus myocutaneous flap placement, complications were seen in 11 patients (65%), with most of them stemming from flap dehiscence (n = 7).
  
  
  CONCLUSIONS
  In our study, the transfer of tissue into the pelvis did not increase surgical times, blood loss, length of stay, or wound complications.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, 320 W 10th Ave, M256 Starling Loving Hall, Columbus, OH 43210, USA. Ravijchokshi@gmail.com
authors.forename: Ravi J
authors.initials: RJ
authors.lastname: Chokshi
authors.forename: Maureen P
authors.initials: MP
authors.lastname: Kuhrt
authors.forename: David
authors.initials: D
authors.lastname: Arrese
authors.forename: Edward W
authors.initials: EW
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010385:Pelvic Exenteration; D010386:Pelvic Neoplasms / Q000628:therapy; D011183:Postoperative Complications; D017568:Rectus Abdominis / Q000637:transplantation; D012189:Retrospective Studies; D013524:Surgical Flaps