Sexual and functional long-term outcomes following advanced pelvic cancer and reconstruction using vertical rectus abdominis myocutaneous and gluteal myocutaneous flap

Autor: Ingrid Palmquist, Pamela Buchwald, Hanin Assi, Anna Persson, Martin Öberg, Marie-Louise Lydrup
Rok vydání: 2019
Předmět:
Male
Colorectal cancer
Rectus Abdominis
030230 surgery
Perineum
Surgically-Created Structures
0302 clinical medicine
Postoperative Complications
Quality of life
Erectile Dysfunction
Surveys and Questionnaires
Aged
80 and over
Pelvic cancer
General Medicine
Organ Size
Middle Aged
Physical Functional Performance
Anus Neoplasms
Oncology
Lower Extremity
030220 oncology & carcinogenesis
Vagina
Female
medicine.symptom
Sexual Health
Sexuality
Adult
medicine.medical_specialty
03 medical and health sciences
medicine
Humans
Muscle Strength
Aged
Retrospective Studies
business.industry
Rectal Neoplasms
Cancer
Posterior compartment of thigh
Plastic Surgery Procedures
medicine.disease
Myocutaneous Flap
Surgery
body regions
Sexual Dysfunction
Physiological
Sexual dysfunction
Erectile dysfunction
Quality of Life
Buttocks
Sexual function
business
Follow-Up Studies
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 47(4)
ISSN: 1532-2157
Popis: Introduction After extensive pelvic surgery for cancer two flap types are used at Skane University Hospital (SUS), Sweden for perineal reconstruction: vertical rectus abdominis myocutaneous flap and gluteal flap with or without vaginal reconstruction. The objective was to study the long-term outcomes in patients treated for advanced pelvic cancer receiving a flap. Method Patients with pelvic cancer subjected to surgery including perineal reconstruction between January 2010 and August 2016 at SUS were included retrospectively. Participating patients were scheduled for an out-patient visit. Questionnaires addressing quality of life, (QLQ-C30 and EQ-5D) and sexual function (FSFI and IIEF) were filled in. Sensitivity test, using monofilaments on the gluteal/posterior thigh area, neovaginal measurements using silicon gauges and muscular functionality tests (timed stands test and stairs test) were performed. Results Thirty-six (24 women, 12 males) out of 71 invited patients conceded participation. Patients scored a median of 85/100 regarding global health using EQ-5D. All women reported sexual dysfunction and 75% (9/12) of men reported severe erectile dysfunction. Neovaginal measurements showed adequate reconstructions. Sensitivity test implied decreased sensitivity on the operated side compared to the unoperated side in patients with gluteal flap. Both physical tests demonstrated adequate muscular functionality in everyday life activities after reconstructions using gluteal flap. Conclusion This long-term follow up after extensive surgery treating pelvic cancer with perineal flap reconstruction implies high quality of life, good muscular functionality and adequate neovaginal measurements. However sexual function is impaired among both sexes and sensitivity in the surgical area of the gluteal flap is decreased.
Databáze: OpenAIRE
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