Inferiorly based rectus abdominis myocutaneous flaps in surgical oncology: Indications, technique, and experience in 37 patients

Abdominoperineal Resection for Anal Cancer

“…It can also be used to fill the pelvis and reconstruct the perineum and vagina. In the study by Bell et al 23 26 of 31 patients had single-stage RAM flap reconstruction during surgery for recurrent disease, persistent anal cancer, or low rectal cancer. Only ten patients had received preoperative radiotherapy with more than 60 Gy; 27/31 patients achieved complete perineal wound healing by 3 weeks.…”

“…In our opinion, in elderly patients, the quality of the abdominal wall is often insufficient to allow this technique. In the study by Bakx et al 26 based on 37 patients, including 9 with cancer of the anal cancer, 4 developed an incisional hernia at the site of harvesting of the RAM flap and 2 required revisional surgery. Publications in this field, must therefore, have a long-term follow-up in order to detect late in addition to early complications.…”

Management of recurrent rectal cancer: A population based study in greater Amsterdam

“…As has been shown previously, radical resection of locally recurrent disease can achieve longterm survival [4,[13][14][15]24] and should, therefore, be aimed at, even if extended resection (e.g. abdominosacral resection or exenteration) [16,25,26] or flap-reconstruction [27] is required. Sur vival in patients treated with non-radical surgery and patients treated with radiotherapy and/or chemotherapy without surgery was comparable, but was significantly worse in patients not treated with surgery, radiotherapy or chemotherapy.…”

Component Separation Improves Outcomes in VRAM Flap Donor Sites with Excessive Fascial Tension

“…10 Multiple studies of VRAM flap perineal reconstruction in rectal cancer salvage surgery have shown that long-term survival and low perineal morbidity are achievable with an acceptable abdominal wall complication rate. [13][14][15][16][17][18] In a series of 48 patients, the most common abdominal wall complication after VRAM flap harvest was fascial dehiscence in seven patients (15 percent) after primary fascial closure of a deficient anterior rectus sheath. 18 Fascial dehiscence is one of the most difficult abdominal wall complications to manage, as it often manifests in the immediate postoperative period.…”