V-Y Bilateral gluteus maximus myocutaneous advancement flap in the reconstruction of large perineal defects after resection of pelvic malignancies

• Published in: Colorectal disease 2009-06, Vol.11 (5), p.508-512
• Main Authors: Di Mauro, D., D'Hoore, A., Penninckx, F., De Wever, I., Vergote, I., Hierner, R.
• Format: Article
• Language: English
• Subjects: abdomino-perineal rectum excision; Adult; Aged; Anus Neoplasms - surgery; Buttocks; Female; Gluteus maximus myocutaneus flap; Humans; Male; Middle Aged; Muscle, Skeletal - surgery; Neoplasm Recurrence, Local - surgery; Pelvic Neoplasms - surgery; perineal reconstruction; Perineum - surgery; Postoperative Complications - etiology; Rectal Neoplasms - surgery; Surgical Flaps; Vulvar Neoplasms - surgery
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2008.01641.x

Objective  To evaluate the role of the V‐Y bilateral gluteus maximus myocutaneous flap (GLM) in the reconstruction of large perineal defects after wide surgical resections for pelvic malignancies. Method  Twelve consecutive patients (seven females and five males), of mean age 59 years (36–78), with primary or recurrent pelvic malignancies (rectal, anal and vulvar carcinoma), underwent either abdomino‐perineal rectum excision with partial sacrectomy or total pelvic exenteration. The perineal defect was reconstructed by means of a GLM flap. Intra‐operative blood loss, operative time, hospital stay, postoperative complications and long‐term outcome were retrospectively assessed. Results  One patient died postoperatively. All the remaining patients had at least one early and/or late complication. After a mean follow‐up of 31.2 months, seven patients were alive. No major functional impairment in daily activities was observed. Five patients experienced a slight discomfort in either walking, sitting or cycling. Conclusion  Gluteus maximus myocutaneus flap is a useful technique for the repair of perineo‐pelvic defects after abdomino‐perineal rectum excision with partial sacrectomy.