Short-term outcomes following beyond total mesorectal excision and reconstruction using myocutaneous flaps: A retrospective cohort study
| Autor: | Martin Öberg, Ingrid Palmquist, Hanin Assi, Anna Persson, Marie-Louise Lydrup, Pamela Buchwald |
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| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer Rectus Abdominis Dehiscence Perineum Myocutaneous Flaps Humans Medicine Pelvic Neoplasms Retrospective Studies Rectal Neoplasms business.industry Mortality rate Medical record Retrospective cohort study General Medicine Plastic Surgery Procedures medicine.disease Myocutaneous Flap Total mesorectal excision Surgery Oncology Female Complication business |
| Zdroj: | European Journal of Surgical Oncology. 48:1161-1166 |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2021.11.001 |
| Popis: | Introduction Beyond total mesorectal excision (bTME) offers long-term survival in patients with advanced pelvic malignancy. At Skane University Hospital (SUS) Malmo in Sweden, the vertical rectus abdominis musculocutaneous (VRAM) and gluteal maximus (GM) flap have been used for perineal reconstruction to promote healing and functional outcomes after significant tissue loss. This study aims to examine 90-day overall and flap-specific complications in patients with advanced pelvic cancer treated with bTME and perineal flap reconstruction. Method This retrospective study conducted at SUS included patients undergoing surgery between 01 January 2010 and 01 August 2016. Patients’ data were gathered through medical chart reviews. The Clavien-Dindo (CD) classification system was used to classify surgical and medical postoperative complications. Flap-specific complications were evaluated regardless of CD classification. Results One hundred five patients (51 men, 54 women) underwent bTME surgery with perineal reconstruction, with VRAM flaps used in 27 (26%) patients, GM flaps in 51 (49%) patients and GM flaps with vaginal reconstruction in 27 (26%) patients. The 90-day mortality rate was one (1%), despite surgical CD ≥ III and/or medical CD ≥ II complications affecting 51 (48%) patients. Partial perineal dehiscence was noted in 45 (43%) patients, mostly treated conservatively. At the first outpatient postoperative visit (median, 42 days), flap healing was complete in 47 (45%) patients. Conclusion bTME surgery in pelvic cancer patients with perineal flap reconstruction using VRAM or GM flaps results in high overall and flap complication rates, but low mortality. Most complications can be conservatively treated. |
| Databáze: | OpenAIRE |
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