Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024
A pedicled anterolateral thigh flap decreased the risk of empty pelvis syndrome following total pelvic exenteration.
СтатьяОценочное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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.
Hirata Shintaro, Kanemitsu Yukihide, Moritani Konosuke, Arikawa Masaki, Kudose Yozo, Takamizawa Yasuyuki, Inoue Manabu, Tsukamoto Shunsuke, Daiko Hiroyuki, Akazawa Satoshi
Аннотация
AIM: Total pelvic exenteration (TPE) can be complicated by empty pelvis syndrome (EPS), and none of the currently available procedures completely mitigate this problem. The aim of this study was to evaluate the feasibility and effectiveness of a pedicled anterolateral thigh (p-ALT) flap for preventing EPS.
METHOD: All cases of TPE at the National Cancer Center Hospital in Tokyo between 2008 and 2022 were retrospectively reviewed. The main indication for TPE was colorectal cancer, with some other malignancies. Background factors, surgical outcomes and postoperative complications were compared between patients who underwent primary suture closure (the PC group) and those who underwent p-ALT flap reconstruction (the flap group).
RESULTS: A total of 114 patients underwent TPE during the study period. Twenty patients in whom a different procedure was performed or a different flap was used for reconstruction were excluded, leaving 94 for analysis (PC group, n = 54; flap group, n = 40). There was no significant between-group difference in patient characteristics. Severe pelvic abscess developed in 12 patients (22.2%) in the PC group and 2 (5%) in the flap group. Multivariable analysis identified a significantly lower risk of severe pelvic abscess in the p-ALT flap reconstruction (OR 0.07, 95% CI 0.01-0.58, p = 0.01). EPS-related readmissions were more common in the PC group [37.0% (20/54) vs. 25% (10/40)].
CONCLUSIONS: The risk of severe pelvic abscesses and readmission for EPS was significantly lower after perineal reconstruction with a p-ALT flap. Perineal reconstruction with this flap is a feasible and effective method in TPE.
METHOD: All cases of TPE at the National Cancer Center Hospital in Tokyo between 2008 and 2022 were retrospectively reviewed. The main indication for TPE was colorectal cancer, with some other malignancies. Background factors, surgical outcomes and postoperative complications were compared between patients who underwent primary suture closure (the PC group) and those who underwent p-ALT flap reconstruction (the flap group).
RESULTS: A total of 114 patients underwent TPE during the study period. Twenty patients in whom a different procedure was performed or a different flap was used for reconstruction were excluded, leaving 94 for analysis (PC group, n = 54; flap group, n = 40). There was no significant between-group difference in patient characteristics. Severe pelvic abscess developed in 12 patients (22.2%) in the PC group and 2 (5%) in the flap group. Multivariable analysis identified a significantly lower risk of severe pelvic abscess in the p-ALT flap reconstruction (OR 0.07, 95% CI 0.01-0.58, p = 0.01). EPS-related readmissions were more common in the PC group [37.0% (20/54) vs. 25% (10/40)].
CONCLUSIONS: The risk of severe pelvic abscesses and readmission for EPS was significantly lower after perineal reconstruction with a p-ALT flap. Perineal reconstruction with this flap is a feasible and effective method in TPE.