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02-02-2023 | Radiotherapy | Original Paper

30 days postoperative outcome associated with vertical rectus abdominis myocutaneous (VRAM) flap reconstruction after pelvic surgery

Authors: Thomas Vestermark Thomsen, M.D., Pernille Warming, M.D., Emir Hasanbegovic, M.D., Mikkel Børsen Rindom, M.D., ph.d., Lars Bjørn Stolle, M.D., Associate Professor, ph.d.

Published in: European Journal of Plastic Surgery | Issue 5/2023

Abstract

Background

Following advanced malignancy in the pelvis, reconstruction of the defect arising from the primary surgical procedure is often required. This study compares patient demography and 30-days postoperative donor and recipient site complications in patients treated with a pedicled transpelvic Vertical Rectus Abdominis Myocutaneous (ptVRAM) flap.

Methods

Sixty-seven patients treated with a ptVRAM flap in 2015 and 2016 were included in the study. Patient demography, surgical indication, treatment, and surgical data were compared between patients with and without complications. Fisher’s exact test and the Mann-Whitney U test were used to compute p-values.

Results

This study shows a total donor and recipient site complication rate of 42% (n = 28) and the total 3-year survival was 73% (n = 49). Patients with a BMI ≥ 32 kg m^-² showed a significant correlation (p = 0.03) with postoperative complications. Smokers, patients with total vaginal reconstruction, and patients with one or more comorbidities were found to have a non-significant correlation with total postoperative complications (p = 0.13, p = 0.16, p = 0.17).

Conclusions

PtVRAM flaps can be used in the reconstruction of pelvic defects following advanced malignancies in patients previously treated with neoadjuvant chemo- or radiotherapy. Our results fall well within the findings of other studies and add to our knowledge of the surgical implications of treating perineal defects.

Level of Evidence: Level IV, risk / prognostic study.

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Title: 30 days postoperative outcome associated with vertical rectus abdominis myocutaneous (VRAM) flap reconstruction after pelvic surgery
Authors: Thomas Vestermark Thomsen, M.D.
Pernille Warming, M.D.
Emir Hasanbegovic, M.D.
Mikkel Børsen Rindom, M.D., ph.d.
Lars Bjørn Stolle, M.D., Associate Professor, ph.d.
Publication date: 02-02-2023
Publisher: Springer Berlin Heidelberg
Keyword: Radiotherapy
Published in: European Journal of Plastic Surgery / Issue 5/2023
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI: https://doi.org/10.1007/s00238-022-02022-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

30 days postoperative outcome associated with vertical rectus abdominis myocutaneous (VRAM) flap reconstruction after pelvic surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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