BJOG : an international journal of obstetrics and gynaecology · 2025
Vulval Flap Reconstruction in Women With Benign, Preneoplastic and Malignant Vulval Conditions: A Prospective Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kwong Fong Lien, Pounds Rachel, Farah Yasmin, Yap Jason K W
Аннотация
OBJECTIVES: To (i) evaluate the surgical morbidity, (ii) identify correlates of these and, (iii) explore whether flap reconstruction following vulvectomy improves patient symptoms and quality of life.
DESIGN: Single arm prospective study.
SETTING: Single tertiary vulval centre, UK.
POPULATION: Consecutive cases of women undergoing radical vulvectomy and flap reconstructions for benign and (pre)invasive vulval conditions.
METHODS: Prospective data collection from April 2020-February 2024. All women were given two validated questionnaires preoperatively and at 3-, 6- and 12-months to evaluate their satisfaction with the aesthetic, genitourinary and psychosexual outcomes.
MAIN OUTCOME MEASURES: Early and late complications within 30 days. Patient reported outcome measures preoperatively and post-reconstruction.
RESULTS: 136 flaps in 69 women were analysed. 92.6% (126/136) and 83.1% (113/136) flaps developed none-to-mild complications at 7 days, and between days 8 to 30, respectively. Five necrotic flaps in two patients were surgically debrided. All flaps had healed/healing at 30 days. We did not identify any correlates of complications. At 12 months, women reported an improvement in genital symptoms (p < 0.001). 80.4% (37/46) reported no urinary incontinence vs. 48.1% (26/54) preoperatively, p = 0.0038. 24.4% (11/45) were sexually active vs. 9.3% (5/54) preoperatively, p = 0.0410. More women felt attractive (p = 0.0498), were satisfied with their body (p = 0.0407) and comfortable in intimate situations (p = 0.0273). 88.9% (40/45) stated that reconstruction helped with acceptance of their cancer diagnosis and surgery.
CONCLUSIONS: Locoregional flap reconstruction has low surgical morbidity, leads to a significant improvement in genitourinary and psychosexual functions. In women with cancer, reconstruction supports women to cope with their diagnosis.
DESIGN: Single arm prospective study.
SETTING: Single tertiary vulval centre, UK.
POPULATION: Consecutive cases of women undergoing radical vulvectomy and flap reconstructions for benign and (pre)invasive vulval conditions.
METHODS: Prospective data collection from April 2020-February 2024. All women were given two validated questionnaires preoperatively and at 3-, 6- and 12-months to evaluate their satisfaction with the aesthetic, genitourinary and psychosexual outcomes.
MAIN OUTCOME MEASURES: Early and late complications within 30 days. Patient reported outcome measures preoperatively and post-reconstruction.
RESULTS: 136 flaps in 69 women were analysed. 92.6% (126/136) and 83.1% (113/136) flaps developed none-to-mild complications at 7 days, and between days 8 to 30, respectively. Five necrotic flaps in two patients were surgically debrided. All flaps had healed/healing at 30 days. We did not identify any correlates of complications. At 12 months, women reported an improvement in genital symptoms (p < 0.001). 80.4% (37/46) reported no urinary incontinence vs. 48.1% (26/54) preoperatively, p = 0.0038. 24.4% (11/45) were sexually active vs. 9.3% (5/54) preoperatively, p = 0.0410. More women felt attractive (p = 0.0498), were satisfied with their body (p = 0.0407) and comfortable in intimate situations (p = 0.0273). 88.9% (40/45) stated that reconstruction helped with acceptance of their cancer diagnosis and surgery.
CONCLUSIONS: Locoregional flap reconstruction has low surgical morbidity, leads to a significant improvement in genitourinary and psychosexual functions. In women with cancer, reconstruction supports women to cope with their diagnosis.