Morbidity associated with the immediate vertical rectus abdominus myocutaneous flap reconstruction after radical pelvic surgery
| Autor: | M. J. Proctor, Frank A. Frizelle, Alexander G. Heriot, A. Chauhan, K. Sent‐Doux, A. C. Lynch, Terry Creagh, D. A. Westwood, Simon Donahoe, Christopher Wakeman |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Rectus Abdominis Perineum law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications Randomized controlled trial law medicine Humans In patient Major complication Pelvic surgery Aged Retrospective Studies Aged 80 and over Univariate analysis Abdominoperineal resection business.industry Gastroenterology Middle Aged Plastic Surgery Procedures Myocutaneous Flap Surgery Radiation therapy 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Smoking status Female Morbidity business |
| Zdroj: | Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and IrelandReferences. 22(5) |
| ISSN: | 1463-1318 |
| Popis: | AIM Patients who undergo radical pelvic surgery often have problems with perineal wound healing and pelvic collections. While there is recognition of the perineal morbidity, there also remains uncertainty around the benefit of vertical rectus abdominus myocutaneous (VRAM) flaps due to the balance between primary healing and the complications associated with this form of reconstruction. This study aimed to evaluate factors associated with significant flap and donor site related complications following VRAM flap reconstruction for radical pelvic surgery. METHOD A retrospective analysis of VRAM flap related complications was undertaken from prospectively maintained databases for all patients undergoing radical pelvic surgery (2001- 2017) in two cancer centres. RESULTS In all, 154 patients were identified [median age 62 years (range 26-89 years), 80 (52%) men]. Thirty-three (21%) patients experienced significant donor or flap related complications. Major complications (Clavien-Dindo ≥ 3) related to the abdominal donor site occurred in nine (6%) patients, while those related to the flap or perineal site occurred in 28 (18%) patients. Only smoking (P = 0.003) and neoadjuvant radiotherapy (P = 0.047) were associated with the development of significant flap related complications on univariate analysis. Flap related complications resulted in a significantly longer hospital stay (P |
| Databáze: | OpenAIRE |
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