A hundred patients with vertical rectus abdominis myocutaneous (VRAM) flap for pelvic reconstruction after total pelvic exenteration.

Abstract

PURPOSE:

We analysed the outcomes of a series of 100 consecutive patients with anorectal cancer with neoadjuvant radiochemotherapy and abdominoperineal exstirpation or total pelvic exenteration, who received a transpelvic vertical rectus abdominis myocutaneous (VRAM) flap for pelvic, vaginal and/or perineal reconstruction and compare a cohort to patients without VRAM flaps.

METHODS:

Within a 10-year period (2003-2013) in our institution 924 patients with rectal cancer stage y0 to y IV were surgically treated. Data of those 100 consecutive patients who received a transpelvic VRAM flap were collected and compared to patients without flaps.

RESULTS:

In 100 consecutive patients with transpelvic VRAM flaps, major donor site complications occurred in 6 %, VRAM-specific perineal wound complications were observed in 11 % of the patients and overall 30-day mortality was 2 %.

CONCLUSIONS:

The VRAM flap is a reliable and safe method for pelvic reconstruction in patients with advanced disease requiring pelvic exenteration and irradiation, with a relatively low rate of donor and recipient site complications. In this first study, to compare a large number of patients with VRAM flap reconstruction to patients without pelvic VRAM flap reconstruction, a clear advantage of simultaneous pelvic reconstruction is demonstrated.

• Authors: R E Horch, W Hohenberger, A Eweida, U Kneser, K Weber, A Arkudas, S Merkel, J Göhl, J P Beier
• Journal: International journal of colorectal disease (Int J Colorectal Dis) Vol. 29 Issue 7 Pg. 813-23 (Jul 2014) ISSN: 1432-1262 [Electronic] Germany
• PMID: 24752738 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Anus Neoplasms (surgery)
• Chemoradiotherapy
• Female
• Humans
• Male
• Middle Aged
• Myocutaneous Flap
• Neoadjuvant Therapy
• Pelvic Exenteration
• Pelvic Neoplasms (surgery)
• Pelvis (surgery)
• Perineum (surgery)
• Rectal Neoplasms (surgery)
• Surgical Wound Infection
• Vagina (surgery)
• Young Adult