采用改良臀大肌肌皮瓣（IGAP瓣）行经会阴扩大局部切除术后会阴重建的临床及患者报告结局分析——一项5年回顾性研究

Analysis of clinical and patient-reported outcomes in post-ELAPE perineal reconstruction with IGAP flap - A 5-year review.

作者信息

Pai Ashwin Alke, Young-Sing Quillan, Bera Sudipta, Maheshwari Kavish, Misra Alok

机构信息

Chang Gung Memorial Hospital, Linkou, Taiwan & Wexham Park Hospital, UK.

St George's Hospital, London, UK.

出版信息

JPRAS Open. 2022 Jun 23;34:10-20. doi: 10.1016/j.jpra.2022.06.002. eCollection 2022 Dec.

DOI:10.1016/j.jpra.2022.06.002

PMID:36061405

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9429127/

Abstract

BACKGROUND

Extralevator abdominoperineal excisions (ELAPE) are now the accepted treatment option for low rectal cancers, which result in large perineal defects necessitating reconstruction. The aim of our study was to assess the clinical outcomes as well as the quality-of-life parameters (QOLP) following these reconstructions.

METHODS

A series of 27 patients who underwent ELAPE and immediate reconstruction with inferior gluteal artery perforator flaps (IGAP) between December 2013 to December 2018 were retrospectively analysed on patient demographics, disease and treatment, complications, and QOLP.

RESULTS

With a mean age of 71.6 years, all patients had low rectal cancers and underwent ELAPE (24 open, 3 lap-assisted) and immediate IGAP flap reconstruction. The follow-up period was 1 year. The overall perineal early minor complication rate was 25.9% and the early major complication rate of 14.8%. QOLP, such as tolerance to sit, perineal pain, perineal aesthetics, showed high patient satisfaction of 77.7%, 40.74%, and 66.6%, respectively at 1 year. The perineal hernia rate was 14.8% with all patients being female (p 0.0407; significant).

CONCLUSION

IGAP flaps are a reliable option for reconstructing post-ELAPE defects with good patient satisfaction and outcomes.

摘要

背景

经肛提肌腹会阴联合切除术（ELAPE）目前是低位直肠癌公认的治疗选择，该手术会导致较大的会阴缺损，需要进行重建。我们研究的目的是评估这些重建术后的临床结果以及生活质量参数（QOLP）。

方法

回顾性分析了2013年12月至2018年12月期间接受ELAPE并立即采用臀下动脉穿支皮瓣（IGAP）重建的27例患者的人口统计学资料、疾病及治疗情况、并发症和QOLP。

结果

患者平均年龄71.6岁，均患有低位直肠癌，接受了ELAPE手术（24例开放手术，3例腹腔镜辅助手术）并立即进行了IGAP皮瓣重建。随访期为1年。会阴早期轻微并发症总发生率为25.9%，早期严重并发症发生率为14.8%。生活质量参数，如坐立耐受性、会阴部疼痛、会阴部美观度，在1年时患者满意度分别为77.7%、40.74%和66.6%。会阴疝发生率为14.8%，所有患者均为女性（p = 0.0407；具有显著性）。