Reconstruction of total pelvic exenteration defects with rectus abdominus myocutaneous flaps versus primary closure

Morbidity associated with the immediate vertical rectus abdominus myocutaneous flap reconstruction after radical pelvic surgery

“…The reported incidence of complications such as dehiscence, chronic abscesses, fistulas and delayed healing in patients who undergo direct closure of the perineal wound has been as high as 67% of cases, with even higher rates noted in diabetic and smoking patients, which is compounded in those who have received preoperative radiotherapy . In an attempt to reduce these complications, the use of a vertical rectus abdominus myocutaneous (VRAM) flap to reconstruct the dead space and introduce well‐vascularized healthy tissue has been advocated .…”

Pelvic Exenteration for Rectal Cancer

“…hultman et al 82 reported a study of 70 patients who underwent anorectal resection with reconstruction with or without omental flap and found that the incidence of pelvic complications including abscesses, hernias, bowel obstructions, and fistulas was significantly greater in the group without the omental flap (61% versus 21%; p < 0.01). in a study comparing pelvic reconstruction with a vertical rectus abdominus myocutaenous flap for patients who underwent tPe versus primary closure, Chokshi et al83 found that there was no significant difference between the groups, and, in fact, one of the most common complications was flap dehiscence. Valle et al 84 studied the use of mammary implants in the pelvic cavity following tPe in 28 cases and reported that no fistulas formed or intestinal obstruction.…”

Methods of reconstruction of perineal wounds after abdominoperineal resection. Literature review

“…Наложение первичного шва на рану далеко не всегда позволяет добиться быст-рого закрытия дефекта, приводит к формированию грыж промежности (с частотой до 67 % [43]) и другим, в том числе, инфекционным осложнениям. В арсенале хирур-гов на данный момент есть ряд методов улучшения как непосредственных, так и отдаленных функциональ-ных результатов лечения.…”