Franco Diogo, Almeida Gutemberg, Arnaut Marcio, Arbex Guilherme, Furtado Yara, Franco Talita
Faculty of Medicine, Federal University of Rio de Janeiro, Brazil.
Rev Col Bras Cir. 2012;39(1):54-9.
To analyze the use of immediate reconstruction techniques of the vulva after surgical resection, with fasciocutaneous flaps of the medial and/or posterior thigh.
We conducted a transversal, retrospective study to analyse the outcome of immediate surgical reconstruction with fasciocutaneous flaps in nine patients who underwent vulvectomy from May 2009 to August 2010.
Mean age was 61 years (range 36-82). In 56% of cases, diagnosis was vulvar intraepithelial neoplasia (VIN), usual type. Radical vulvectomy was performed in 45% of patients, simple vulvectomy in 33% and wide resections in 22%. Eleven fasciocutaneous flaps were made, of which 36.3% were flap transpositions from the posterior thigh, 18.2% from the medial thigh, 18.2% were in advancement flaps, 18.2% simple advancement flaps and 9.1% flap rotation from the posterior thigh. There were no major losses of the flaps made.
Thigh fasciocutaneous flaps are currently the best options for immediate reconstruction after resection of vulvar cancer due to the preservation of sensibility and tissue availability in the donor areas. The association of the Plastic Surgeon with the Gynecologist offers tranquility for patients and provides good postoperative results.
分析采用大腿内侧和/或后侧筋膜皮瓣对外阴手术切除后进行即刻重建技术的应用情况。
我们进行了一项横向回顾性研究，以分析2009年5月至2010年8月期间接受外阴切除术的9例患者采用筋膜皮瓣进行即刻手术重建的结果。
平均年龄为61岁（范围36 - 82岁）。56%的病例诊断为外阴上皮内瘤变（VIN），常见类型。45%的患者进行了根治性外阴切除术，33%进行了单纯外阴切除术，22%进行了广泛切除术。共制作了11个筋膜皮瓣，其中36.3%是来自大腿后侧的皮瓣转移，18.2%来自大腿内侧，18.2%是推进皮瓣，18.2%是单纯推进皮瓣，9.1%是来自大腿后侧的皮瓣旋转。所制作的皮瓣没有出现重大坏死。
由于供区保留了感觉功能且有可用组织，大腿筋膜皮瓣目前是外阴癌切除后即刻重建的最佳选择。整形外科医生与妇科医生的协作让患者安心，并能带来良好的术后效果。
Zotero 插件