title: [Pelvic reconstruction after tubular rectumresection (extended abdominoperineal resection combined with extended transpelvic myocutaneous M. rectus abdominis flap (extended VRAM) in low rectum cancer - case series)].
abstract: In advanced lower rectal cancer tubular abdomino-perineal resection (APR) in combination with simultaneous extended distally pedicled vertical rectus abdominis muscle flap (VRAM) facilitates a more radical tumor resection. Additionally a prolapse of small intestine into the pelvis can be blocked and a perineal defect coverage can be achieved. 4 patients have been treated with an interdisciplinary one stage combined tubular APR and extended VRAM. In all cases a R0 resection and a complete defect closure could be achieved.The extended VRAM is an appropriate technique to close the pelvic defect because it originates from a non irradiated area, has a monitor island, and the donor site does not handicap the patient as much as local flaps. This interdisciplinary approach facilitates a more radical tumor resection and thus reduces the risk of recurrence.
authors.affiliation: Klinik für Plastische, Hand- und Wiederherstellungschirurgie, KlinikumStadtSoest, Soest. dahmann@klinikumstadtsoest.de
authors.forename: S
authors.initials: S
authors.lastname: Dahmann
authors.forename: D
authors.initials: D
authors.lastname: Simunec
authors.forename: T
authors.initials: T
authors.lastname: Caylak
authors.forename: L
authors.initials: L
authors.lastname: Biermann
authors.forename: K
authors.initials: K
authors.lastname: Frommhold
authors.forename: M V
authors.initials: MV
authors.lastname: Meyer-Marcotty
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017773:Pelvic Floor / Q000601:surgery; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps / Q000601:surgery*