Vertical Rectus Abdominis Musculocutaneous Flap Repair Improves Perineal Wound Healing after Abdominoperineal Resection for Irradiated Locally Advanced Rectal Cancer

摘要: Radiotherapy (RT) and subsequent abdominoperineal resection (APR) for locally advanced rectal cancer (LARC) is associated with significant perineal wound morbidity. The aim of the present study was to investigate if vertical rectus abdominis musculocutaneous (VRAM) flap repair after APR in LARC patients improves healing compared direct closure (non-VRAM). (n = 329) operated between January 2006 December 2015 neoadjuvant RT ≥ 25 Gy were identified, including 260 69 non-VRAM VRAM groups, respectively. Perineal assessed 3 months postoperatively, risk factors complications associations short- long-term outcome analyzed. Delayed more frequent group (31.5%) (10.4%) (p < 0.01). In group, 26.9% developed pelvic abscess, 10.1% Significant morbidity (odds ratio [OR] 3.94, 95% confidence interval [CI] 1.72–9.00; p = 0.02), positive circumferential margin (R1; OR 3.64, CI 1.91–6.93; p < 0.01), abscess (OR 3.27, 1.90–5.63; short-course 3.81, 1.75–8.30; p < 0.01). not impaired oncologic outcome. reconstruction perineum an increased rate may protect against development. However, procedure-related incompletely studied procedure should be reserved selected patients.