@article{article_1467973, title={RECONSTRUCTION OPTIONS FOR CHALLENGING PERINEAL DEFECTS}, journal={Journal of Istanbul Faculty of Medicine}, volume={87}, pages={275–282}, year={2024}, DOI={10.26650/IUITFD.1467973}, author={Aksöyler, Dicle and Nergizoğullari, Mehmet Can and Yalçın, Yiğit and Kozanoğlu, Erol and Akalın, Bora Edim and Ercan, Leman Damla and Kulle, Cemil Burak and Polat, Özlem and Dinçer, Müşerref Beril and Minareci, Yağmur and et al.}, keywords={Abdominoperineal rezeksiyon, flep, pelvik ekzenterasyon, perineal rekonstrüksiyon, radyoterapi}, abstract={Objective: Abdominoperineal resection and pelvic exenteration for the surgical treatment of advanced colorectal or gynaecological cancers can result in large perineal defects and severe surgical site morbidity. Several regional flaps can be used to treat radiation- and extirpative surgery-related wound breakdowns. This study aims to retrospectively evaluate the efficiency of different flaps used in the reconstruction of perineal defects.
Material and Method: A retrospective review of pelvic reconstructions performed between May 2021 and August 2023 was conducted, with a 6-month follow-up. Ten patients who underwent abdominoperineal resection with immediate abdominal-based flap (n=4) or thigh-based flap (n=6) reconstruction of the perineal/pelvic defect were evaluated. The two groups were compared in terms of patient characteristics, aetiology, preferred treatment, and postoperative complications.
Result: Five women and five men underwent comprehensive pelvic reconstruction. The mean age was 49.6 years (range 26–76) and mean BMI of 28.6 kg/m2 (range 21.3–50). Five patients had previously undergone radiotherapy. In total, 11 flaps were created based on the type of perineal defect. One patient experienced a minor dehiscence (<5 cm). Two patients experienced major dehiscence (>5 cm), and required reoperation. A patient with Crohn’s disease developed one intra-abdominal abscess because of spontaneous fistula formation. There was no vascular compromise in the flaps.
Conclusion: Repair options vary depending on the nature of the defect and extent of resection. The primary goals of reconstruction are to eliminate pelvic dead space and separate the intra-abdominal content from the perineum to prevent herniation and strangulation of the small intestines and to ensure that the perineal wound heals without complications.}, number={4}, publisher={İstanbul Üniversitesi}