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[肛管癌的腹会阴联合切除术:采用腹直肌前肌皮瓣重建会阴]

[Abdominoperineal resection in anal cancer: Reconstruction of the perineum with a myocutaneous flap from the anterior rectus abdominis muscle].

作者信息

Núñez José Enrique Casal, Alvarado Nieves Cáceres, Pereira Alberto de Sanildefonso, Novelle M Ángeles Toscano, Martínez M Teresa García, Albores Patricia Jove

机构信息

Hospital Meixoeiro, Vigo, Pontevedra, España.

出版信息

Cir Esp. 2011 Jan;89(1):31-6. doi: 10.1016/j.ciresp.2010.10.002. Epub 2010 Dec 19.

Abstract

INTRODUCTION

Abdominoperineal resection after radiotherapy has a high rate of perineal wound complications. The aim of this retrospective study was to evaluate the results of perineal reconstruction with a rectus abdominis muscle myocutaneous flap in patients with recurrent or persistent anal cancer.

PATIENTS AND METHOD

Between 2006 and 2010, six male HIV+ patients were treated after initial treatment failure with chemotherapy. An anterior rectal myocutaneous flap was performed after abdominal-perineal excision.

RESULTS

The mean age was 36.3 years (range: 30-42). Primary healing of the perineal wound was achieved in the first thirty days. There were no major complications in the immediate post-surgical period or after a mean follow up of 26.5 months. There were 2 (33.3%) minor complications associated with the perineal wound. There were no complications of the abdominal wall.

CONCLUSION

The use of an anterior rectus abdominis myocutaneous flap in patients with recurrent or persistent anal cancer is associated with a low rate of perineal complications.

摘要

引言

放疗后腹会阴联合切除术的会阴伤口并发症发生率很高。这项回顾性研究的目的是评估腹直肌肌皮瓣用于复发性或持续性肛管癌患者会阴重建的效果。

患者与方法

2006年至2010年间,6名男性HIV阳性患者在初始化疗失败后接受治疗。在腹会阴切除术后行直肠前肌皮瓣手术。

结果

平均年龄为36.3岁(范围:30 - 42岁)。会阴伤口在术后30天内实现一期愈合。术后即刻及平均随访26.5个月期间均未出现严重并发症。有2例(33.3%)会阴伤口出现轻微并发症。腹壁无并发症。

结论

腹直肌前肌皮瓣用于复发性或持续性肛管癌患者,会阴并发症发生率较低。

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