V-Y Bilateral gluteus maximus myocutaneous advancement flap in the reconstruction of large perineal defects after resection of pelvic malignancies

Authors: Di Mauro, D.; D'Hoore, A.¹; Penninckx, F.¹; De Wever, I.²; Vergote, I.³; Hierner, R.⁴

Source: Colorectal Disease, Volume 11, Number 5, June 2009 , pp. 508-512(5)

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Abstract:

Objective

To evaluate the role of the V-Y bilateral gluteus maximus myocutaneous flap (GLM) in the reconstruction of large perineal defects after wide surgical resections for pelvic malignancies. Method

Twelve consecutive patients (seven females and five males), of mean age 59 years (36-78), with primary or recurrent pelvic malignancies (rectal, anal and vulvar carcinoma), underwent either abdomino-perineal rectum excision with partial sacrectomy or total pelvic exenteration. The perineal defect was reconstructed by means of a GLM flap. Intra-operative blood loss, operative time, hospital stay, postoperative complications and long-term outcome were retrospectively assessed. Results

One patient died postoperatively. All the remaining patients had at least one early and/or late complication. After a mean follow-up of 31.2 months, seven patients were alive. No major functional impairment in daily activities was observed. Five patients experienced a slight discomfort in either walking, sitting or cycling. Conclusion

Gluteus maximus myocutaneus flap is a useful technique for the repair of perineo-pelvic defects after abdomino-perineal rectum excision with partial sacrectomy.

Keywords: Gluteus maximus myocutaneus flap; perineal reconstruction; abdomino-perineal rectum excision

Document Type: Research article

DOI: 10.1111/j.1463-1318.2008.01641.x

Affiliations: 1: Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium 2: Department of Oncologic Surgery, University Hospital Gasthuisberg, Leuven, Belgium 3: Department of Gynaecology and Obstetrics, University Hospital Gasthuisberg, Leuven, Belgium 4: Department of Plastic and Reconstructive Surgery, University Hospital Gasthuisberg, Leuven, Belgium