TY  - JOUR
T1  - VAginal reconstruction following resection of primary locally advanced and recurrent colorectal malignancies
AU  - D'Souza DN, Pera M, Nelson H, Finical SJ, Tran NV
Y1  - 2003/12/01
N1  - 10.1001/archsurg.138.12.1340
JO  - Archives of Surgery
SP  - 1340
EP  - 1343
VL  - 138
IS  - 12
N2  - Hypotheses 
    Vertical rectus abdominus myocutaneous flap reconstruction facilitates healing within the radiated pelvis and preserves the possibility of subsequent sexual function in patients with colorectal cancer who require partial or complete resection of the vagina.Design 
    A retrospective review of a consecutive series of patients.Setting 
    A tertiary referral center.Patients 
    All patients undergoing surgical treatment of locally advanced or recurrent colorectal cancer and vertical rectus abdominus myocutaneous flap reconstruction of the vagina.Intervention 
    Vertical rectus abdominus myocutaneous flap reconstruction.Main Outcome Measures 
    Operative feasibility, complications, and sexual function.Results 
    Twelve patients underwent extended resection for primary locally advanced or recurrent colorectal cancer including total or near total vaginectomy. Median age was 47 years. Tumors included 9 rectal adenocarcinomas, 2 anal squamous cell carcinomas, and 1 recurrent cecal adenocarcinoma. Surgical procedures included 8 abdominoperineal resections with posterior exenteration; resection of pelvic tumor and partial vaginectomy in 2 patients with previous abdominoperineal resection; 1 total exenteration; and 1 total proctocolectomy with posterior exenteration. The average operative time for tumor extirpation, irradiation, and reconstruction was more than 9 hours and all patients required blood transfusions. Despite 2 patients having superficial necrosis and 4 having mild wound infections, no patient required reoperation and all achieved complete healing. Five patients reported resuming sexual intercourse.Conclusions 
    The vertical rectus abdominus myocutaneous flap can be successfully used for vaginal reconstruction following resection of locally advanced colorectal cancer. It provides nonirradiated, vascularized tissue that fills the pelvic dead space, allows for stomal placement, and provides a chance for sexual function.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.138.12.1340
UR  - http://dx.doi.org/10.1001/archsurg.138.12.1340
ER  -