Primary Vaginal and Pelvic Floor Reconstruction at the Time of Pelvic Exenteration: A Study of Morbidity

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

“…This form of reconstruction has a low morbidity rate and the IBRAM flap is known for its viability, offering a reliable solution in an often irradiated, and therefore, troublesome area [9][10][11][12][13]. Harvesting the IBRAM flap is relatively easy, especially when a midline laparotomy is used for the initial procedure.…”

Ipsilateral Ileal Conduit Placement at Vertical Rectus Abdominis Myocutaneous Flap Donor Site in Pelvic Exenteration

“…1,2 This procedure affects stoma placement, because such patients require a colostomy in addition to a urinary stoma. Attempts have been made to minimize stoma-related complications by placing both the colostomy and the urinary stoma in the remaining rectus abdominis muscle.…”

May the rectus abdominis myocutaneous flap be the best option for the reconstruction of complicated large defects of pelvic exenteration for vulvar malignancies after pelvic radiation?

“…Various authors have linked reconstructive procedures with improved primary healing, reduced rates of intestinal complications, and reduced rates of infection [3,6,8]. Nevertheless pelvic irradiation can result in severe radiation fibrosis, necrosis, and fistulas [9]. These situations increase the concerns on the success of reconstructive operation after exenteration.…”

“…It has been stated that, in some author's opinion, RAM flap should be the first choice in neovaginal reconstruction because of it's remarkable advantages over than gracilis flap; reliable vascular pedicle, acceptable donor site scar and the ease of bringing the flap through pelvis via primary exenterative incision [4,7]. Flap necrosis rate is significantly lower than gracilis flaps [9].…”

“…Reconstructions without creating a neovagina were found to be associated with high postoperative complications [9,24].…”