Interdisciplinary Surgical Approaches in Vaginal and Perineal Reconstruction of Advanced Rectal and Anal Female Cancer Patients.

VRAM anal cancer rectal cancer transpelvic vertical rectus abdominis myocutaneous flap vaginal reconstruction

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2020
Historique:
received: 06 01 2020
accepted: 16 04 2020
entrez: 2 6 2020
pubmed: 2 6 2020
medline: 2 6 2020
Statut: epublish

Résumé

Relapsing or far advanced rectal and anal cancers remain difficult to treat and require interdisciplinary approaches. Due to modern standard protocols all patients receive irradiation and neoadjuvant chemotherapy-and in case of a relapse a second irradiation-rendering the surgical site prone to surgical site infections and oftentimes long lasting sinus and septic complications after exenteration in the pelvis. Despite an improved overall survival rate in these patients the downside of radical tumor surgery in the pelvis is a major loss of quality of life, especially in women when parts of the vagina need to be resected. Derived from our experince with over 300 patients receiving pelvic and perineal reconstruciton with a transpelvic vertical rectus abdominis myocutaneous (tpVRAM) flap we studied the impact of this surgical technique on the outcomes of female patients with or without vaginal reconstruction following pelvic exenteration. We found out that the tpVRAM flap is reliably perfused and helps to reduce long term wound healing desasters in the irradiated perineal/vaginal/gluteal region.

Identifiants

pubmed: 32477947
doi: 10.3389/fonc.2020.00719
pmc: PMC7237715
doi:

Types de publication

Journal Article

Langues

eng

Pagination

719

Informations de copyright

Copyright © 2020 Horch, Ludolph, Cai, Weber, Grützmann and Arkudas.

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Auteurs

Raymund E Horch (RE)

Department of Plastic and Hand Surgery, University Hospital Erlangen-Friedrich Alexander University of Erlangen-Nuernberg FAU, Erlangen, Germany.

Ingo Ludolph (I)

Department of Plastic and Hand Surgery, University Hospital Erlangen-Friedrich Alexander University of Erlangen-Nuernberg FAU, Erlangen, Germany.

Aijia Cai (A)

Department of Plastic and Hand Surgery, University Hospital Erlangen-Friedrich Alexander University of Erlangen-Nuernberg FAU, Erlangen, Germany.

Klaus Weber (K)

Department of Surgery, University Hospital Erlangen-Friedrich Alexander University of Erlangen-Nuernberg FAU, Erlangen, Germany.

Robert Grützmann (R)

Department of Surgery, University Hospital Erlangen-Friedrich Alexander University of Erlangen-Nuernberg FAU, Erlangen, Germany.

Andreas Arkudas (A)

Department of Plastic and Hand Surgery, University Hospital Erlangen-Friedrich Alexander University of Erlangen-Nuernberg FAU, Erlangen, Germany.

Classifications MeSH