title: Reconstruction of the pelvis and perineum with a free latissimus dorsi myocutaneous flap: a case report.
abstract: Reconstruction of the perineum and pelvic cavity in continuity is an uncommon and difficult challenge. This case describes a 66-year-old man who presented following recurrence of a Dukes' B rectosigmoid adenocarcinoma that had been treated nine years previously by anterior resection,  5-fluorouracil and radiotherapy. His recurrent disease was treated with radical pelvic exenteration with formation of an end colostomy and urinary ileal conduit.  A post-operative pelvic collection necessitated incisional drainage via the perineum. This resulted in a perineal defect in  continuity with the pelvic cavity, neither of which healed in spite of alternate day packing with antiseptic dressings. The perineum and cavity were reconstructed successfully with a microvascular transfer of the latissimus dorsi using the primary gracilis pedicle as recipient donor vessels.
authors.affiliation: Plastic and Reconstructive Surgery Department, Cork University Hospital, Wilton, Cork, Ireland. ingridkieran@yahoo.com
authors.forename: I
authors.initials: I
authors.lastname: Kieran
authors.forename: N
authors.initials: N
authors.lastname: Nugent
authors.forename: M Ó
authors.initials: MÓ
authors.lastname: Riordain
authors.forename: J
authors.initials: J
authors.lastname: Kelly
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010385:Pelvic Exenteration / Q000379:methods*; D010388:Pelvis / Q000601:surgery; D010502:Perineum / Q000601:surgery; D012004:Rectal Neoplasms / Q000601:surgery*; D012811:Sigmoid Neoplasms / Q000601:surgery*