Myocutaneous flap reconstruction of the pelvis after abdominoperineal excision

摘要: Objective  Perineal wound complications after abdominoperineal excision (APE) for anorectal cancer represent a considerable source of morbidity patients. Strategies to improve healing include reconstruction with myocutaneous flaps. This is an evidence-based review pelvic defects APE, using rectus abdominus (RAM), gracilis and gluteus maximus flaps. Method  A Pubmed search was performed MESH headings. Results  Thirty-six studies reported outcomes interest. Five controlled improved APE chemoradiotherapy RAM two reconstruction. There were seven patients total flap loss reconstruction, in combined 300 eight complete cutaneous necrosis 83 patients. Conclusion  Data from the support use flaps single-stage presence chemoradiotherapy. Ultimately, choice depends on goals size defect availability donor tissue. The implications expanding role radiotherapy treatment low rectal radical dissection achieve negative circumferential margins, necessitate close co-operation between colorectal reconstructive surgeons reduced morbidity.