Recent Experience with Abdominal Perineal Resection with Vertical Rectus Abdominis Myocutaneous Flap Reconstruction after Preoperative Pelvic Radiation
作者： Marcelo W. Hinojosa , Dhavan A. Parikh , Raman Menon , Garrett A. Wirth , Michael J. Stamos
DOI: 10.1177/000313480907501029
关键词: Rectus abdominis muscle 、 Abdomen 、 Pelvic cavity 、 Radiation therapy 、 Perineum 、 Pelvis 、 Medicine 、 Abdominoperineal resection 、 Surgery 、 Vaginectomy
摘要: Abdominoperineal resection (APR) after pelvic radiation can be complicated by an increased rate of difficult to treat perineal wound complications. In effort improve postoperative morbidity APR, myocutaneous flap reconstructions have been used. We review our recent experience with APR vertical rectus abdominis reconstruction (VRAM) preoperative radiation. A retrospective patients who underwent VRAM from December 2004 July 2008 was conducted. Outcome measures included demographics, comorbidities, length stay, complications, and mortality. Fifteen a mean age 61 +/- 9 years reconstruction. Five also required posterior vaginectomy the APR. Indications for were rectal cancer (n = 14, 93%) anal canal 1, 7%). There no intraoperative Mean estimated blood loss 635 446 mL transfusion requirements 1 2 units. hospital stay 11 4 days. Six (40%) had minor One (7%) patient infection requiring reoperation washout reapproximation. 30-day or in-hospital All flaps remained viable through follow-up. performed safely limited complications
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sci-hub.st 参考文章(20)
R. Pollock, D. Ota, J. M. Jessup, S. S. Kroll, Transpelvic rectus abdominis flap reconstruction of defects following abdominal-perineal resection. American Surgeon. ,vol. 55, pp. 632- 637 ,(1989)
Daniel E. Abbott, Amy L. Halverson, Jeffrey D. Wayne, John Y. S. Kim, Mark S. Talamonti, Gregory A. Dumanian, The oblique rectus abdominal myocutaneous flap for complex pelvic wound reconstruction. Diseases of The Colon & Rectum. ,vol. 51, pp. 1237- 1241 ,(2008) , 10.1007/S10350-008-9359-4
T.J. O’Kelly, J.O. Jansen, Non-restorative surgery for rectal cancer: indications in 2003. Surgeon-journal of The Royal Colleges of Surgeons of Edinburgh and Ireland. ,vol. 1, pp. 342- 346 ,(2003) , 10.1016/S1479-666X(03)80069-0
Andrew K.M. Khoo, John M. Skibber, Ayman Sameh Nabawi, Ali Gurlek, Adel A. Youssef, Baogang Wang, Geoffrey L. Robb, Michael J. Miller, Indications for immediate tissue transfer for soft tissue reconstruction in visceral pelvic surgery. Surgery. ,vol. 130, pp. 463- 469 ,(2001) , 10.1067/MSY.2001.116416
James P. Anthony, The Recalcitrant Perineal Wound After Rectal Extirpation Archives of Surgery. ,vol. 125, pp. 1371- 1377 ,(1990) , 10.1001/ARCHSURG.1990.01410220155022
M. A. Chadwick, D. Vieten, E. Pettitt, A. R. Dixon, A. M. Roe, Short course preoperative radiotherapy is the single most important risk factor for perineal wound complications after abdominoperineal excision of the rectum Colorectal Disease. ,vol. 8, pp. 756- 761 ,(2006) , 10.1111/J.1463-1318.2006.01029.X
Wilbur L Baird, T Roderick Hester, Foad Nahai, John Bostwick, Management of Perineal Wounds Following Abdominoperineal Resection With Inferior Gluteal Flaps Archives of Surgery. ,vol. 125, pp. 1486- 1489 ,(1990) , 10.1001/ARCHSURG.1990.01410230080014
Roger D. Hurst, Lawrence J. Gottlieb, Pierfilippo Crucitti, Marcovalerio Melis, Michele Rubin, Fabrizio Michelassi, Primary closure of complicated perineal wounds with myocutaneous and fasciocutaneous flaps after proctectomy for Crohn's disease. Surgery. ,vol. 130, pp. 767- 773 ,(2001) , 10.1067/MSY.2001.117100
S. W. Bell, N. Dehni, M. Chaouat, J. C. Lifante, R. Parc, E. Tiret, Primary rectus abdominis myocutaneous flap for repair of perineal and vaginal defects after extended abdominoperineal resection. British Journal of Surgery. ,vol. 92, pp. 482- 486 ,(2005) , 10.1002/BJS.4857
Susan Galandiuk, Jeffrey Jorden, Suhal Mahid, Michael H. McCafferty, Gordon Tobin, The use of tissue flaps as an adjunct to pelvic surgery American Journal of Surgery. ,vol. 190, pp. 186- 190 ,(2005) , 10.1016/J.AMJSURG.2005.05.009