VRAM Flap for Pelvic Floor Reconstruction after Pelvic Exenteration and Abdominoperineal Excision.

Autor: Faur IF; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania.; X Department of General Surgery, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Clim A; IInd Obstetric and Gynecology Clinic 'Dominic Stanca', 400124 Cluj-Napoca, Romania., Dobrescu A; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania.; X Department of General Surgery, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Prodan C; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania., Hajjar R; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania., Pasca P; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania., Capitanio M; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania., Tarta C; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania.; X Department of General Surgery, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Isaic A; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania.; X Department of General Surgery, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Noditi G; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania.; X Department of General Surgery, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Nati I; 2nd Department of Obstetric & Ginecology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Victor Babeș Street Number 8, 400347 Cluj-Napoca, Romania.; Ist Clinic of Oncological Surgery, Oncological Institute 'Prof. Dr. I. Chiricuta', 400015 Cluj-Napoca, Romania., Totolici B; Ist Clinic of General Surgery, Arad County Emergency Clinical Hospital, 310158 Arad, Romania.; Department of General Surgery, Faculty of Medicine, 'Vasile Goldiș' Western University of Arad, 310025 Arad, Romania., Duta C; IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania.; X Department of General Surgery, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Lazar G; 2nd Department of Obstetric & Ginecology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Victor Babeș Street Number 8, 400347 Cluj-Napoca, Romania.; Ist Clinic of Oncological Surgery, Oncological Institute 'Prof. Dr. I. Chiricuta', 400015 Cluj-Napoca, Romania.
Jazyk: angličtina
Zdroj: Journal of personalized medicine [J Pers Med] 2023 Dec 14; Vol. 13 (12). Date of Electronic Publication: 2023 Dec 14.
DOI: 10.3390/jpm13121711
Abstrakt: Due to the still large number of patients diagnosed with pelvic neoplasms (colorectal, gynecological, and urological) in advanced stages right from the initial diagnosis, surgery represents the mainstay of treatment, often implying wide, eventually multi-organ resections in order to achieve negative surgical margins. Perineal wound morbidity, particularly in extralevator abominoperineal excision, leads to complications and local infection rates of up to 40%. Strategies to reduce postoperative wound complications are being pursued to address this issue. The VRAM flap remains the gold standard for autologous reconstruction after pelvic oncological resection; it was initially designed for abdominal wall defects and later expanded for large pelvic tissue defects. The flap's application is based on its physical characteristics, including abundant tissue and a generous skin paddle, which effectively obliterates dead space after exenterations. The generous skin paddle offers good cosmetic and functional outcomes at the recipient site. This article describes the case of a patient histopathologically diagnosed with stage IIIA squamous cell carcinoma of the uterine cervix who received multimodal onco-surgical treatment. The surgical mainstay of this treatment is pelvic exenteration. Pelvic reconstruction after this major surgery was performed using a vertical flap with the rectus abdominis.
Databáze: MEDLINE
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