Bognár Gábor, Novák András, István Gábor, Lóderer Zoltán, Ledniczky György, Ondrejka Pál
Semmelweis Egyetem II. sz. Sebészeti Klinika 1125 Budapest.
Magy Seb. 2012 Oct;65(5):388-95. doi: 10.1556/MaSeb.65.2012.5.10.
Perineal wound healing problems following extended abdomino-perineal resection of ano-rectal cancer represent a great challenge to the surgeon. Perineal soft-tissue reconstruction with a myocutan flap was thought to reduce surgical wound healing complications. A review of the relevant literature was carried out on perineal soft-tissue reconstruction with rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal rectal resection for cancer. The more commonly used neoadjuvant chemo- and radiotherapy as well as extended surgical radicality resulted in increased perioperative risks, therefore combined procedures between the colorectal and plastic surgical teams are inevitable. This case report illustrates the above trend.
肛管直肠癌扩大腹会阴联合切除术后的会阴伤口愈合问题对外科医生来说是一个巨大挑战。采用肌皮瓣进行会阴软组织重建被认为可减少手术伤口愈合并发症。我们对腹会阴联合直肠癌扩大切除术后采用腹直肌肌皮(VRAM)瓣进行会阴软组织重建的相关文献进行了综述。更常用的新辅助放化疗以及扩大的手术根治性导致围手术期风险增加,因此结直肠外科团队与整形外科团队之间的联合手术不可避免。本病例报告说明了上述趋势。