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

Overview

Journal Front Oncol

Specialty Oncology

Date 2020 Jun 2

PMID 32477947

Citations 5

Authors

Raymund E Horch

Ingo Ludolph

Aijia Cai

Klaus Weber

Robert Grutzmann

Andreas Arkudas

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Intra- and Early Postoperative Evaluation of Malperfused Areas in an Irradiated Random Pattern Skin Flap Model Using Indocyanine Green Angiography and Near-Infrared Reflectance-Based Imaging and Infrared Thermography.

Muller-Seubert W, Ostermaier P, Horch R, Distel L, Frey B, Cai A J Pers Med. 2022; 12(2).

PMID: 35207725 PMC: 8880010. DOI: 10.3390/jpm12020237.

IGF-I and Hyaluronic Acid Mitigate the Negative Effect of Irradiation on Human Skin Keratinocytes.

Sorgel C, Schmid R, Stadelmann N, Weisbach V, Distel L, Horch R Cancers (Basel). 2022; 14(3).

PMID: 35158856 PMC: 8833477. DOI: 10.3390/cancers14030588.

Personalized Reconstruction of Genital Defects in Complicated Wounds with Vertical Rectus Abdominis Myocutaneous Flaps including Urethral Neo-Orifice.

Horch R, Ludolph I, Arkudas A, Cai A J Pers Med. 2021; 11(11).

PMID: 34834428 PMC: 8620180. DOI: 10.3390/jpm11111076.

[Reconstruction of oncological defects of the perianal region].

Horch R, Ludolph I, Arkudas A Chirurg. 2021; 92(12):1159-1170.

PMID: 33904942 DOI: 10.1007/s00104-021-01394-w.

Donor Site Morbidity of Patients Receiving Vertical Rectus Abdominis Myocutaneous Flap for Perineal, Vaginal or Inguinal Reconstruction.

Schellerer V, Bartholome L, Langheinrich M, Grutzmann R, Horch R, Merkel S World J Surg. 2020; 45(1):132-140.

PMID: 32995931 PMC: 7752873. DOI: 10.1007/s00268-020-05788-5.

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