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

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

doi:10.1016/S2173-5077(11)70006-0

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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.

Keywords:

Anal Cancer

Abdominoperineal Resection

Anterior Rectus Abdominis

Myocutaneous Flap

Radiotherapy

Resumen

Introducción

La resección abdominoperineal tras radioterapia se acompaña de una alta tasa de complicaciones de la herida perineal. El propósito de este estudio retrospectivo fue evaluar los resultados de la reconstrucción perineal con un colgajo miocutáneo de músculo recto abdominal en pacientes con cáncer anal recurrente o persistente.

Pacientes y método

Entre 2006 y 2010, 6 pacientes varones VIH+ fueron tratados después del fracaso del tratamiento inicial con quimio-radioterapia. Tras amputación abdominoperineal, se realizó un colgajo miocutáneo de recto anterior.

Resultados

La media de edad fue de 36,3 años (rango: 30-42). La curación primaria de la herida perineal se consiguió en los primeros treinta días. No hubo complicaciones mayores en el postoperatorio inmediato o tras un seguimiento medio de 26,5 meses. Hubo 2 complicaciones menores (33,3%) relacionadas con la herida perineal. No hubo complicaciones de la pared abdominal.

Conclusión

La utilización de un colgajo miocutáneo del recto anterior del abdomen, en pacientes con cáncer anal recurrente o persistente, se asoció con un bajo índice de complicaciones perineales.

Palabras clave:

Cáncer Anal

Resección Abdominoperineal

Colgajo Miocutáneo Del Recto

Anterior Abdominal

Radioterapia

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