Plastic and Reconstructive Surgery in the Treatment of Oncological Perineal and Genital Defects
Identifieur interne : 007A69 ( Ncbi/Merge ); précédent : 007A68; suivant : 007A70Plastic and Reconstructive Surgery in the Treatment of Oncological Perineal and Genital Defects
Auteurs : Rebekka Brodbeck [Allemagne] ; Raymund E. Horch [Allemagne] ; Andreas Arkudas [Allemagne] ; Justus P. Beier [Allemagne]Source :
- Frontiers in Oncology [ 2234-943X ] ; 2015.
Abstract
Defects of the perineum may result from ablative procedures of different malignancies. The evolution of more radical excisional surgery techniques resulted in an increase in large defects of the perineum. The perineogenital region
Url:
DOI: 10.3389/fonc.2015.00212
PubMed: 26500887
PubMed Central: 4597132
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PMC:4597132Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Plastic and Reconstructive Surgery in the Treatment of Oncological Perineal and Genital Defects</title>
<author><name sortKey="Brodbeck, Rebekka" sort="Brodbeck, Rebekka" uniqKey="Brodbeck R" first="Rebekka" last="Brodbeck">Rebekka Brodbeck</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuernberg</institution>
,<addr-line>Erlangen</addr-line>
,<country>Germany</country>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Horch, Raymund E" sort="Horch, Raymund E" uniqKey="Horch R" first="Raymund E." last="Horch">Raymund E. Horch</name>
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,<addr-line>Erlangen</addr-line>
,<country>Germany</country>
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<country xml:lang="fr">Allemagne</country>
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<author><name sortKey="Arkudas, Andreas" sort="Arkudas, Andreas" uniqKey="Arkudas A" first="Andreas" last="Arkudas">Andreas Arkudas</name>
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,<addr-line>Erlangen</addr-line>
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<author><name sortKey="Beier, Justus P" sort="Beier, Justus P" uniqKey="Beier J" first="Justus P." last="Beier">Justus P. Beier</name>
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<country xml:lang="fr">Allemagne</country>
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<series><title level="j">Frontiers in Oncology</title>
<idno type="eISSN">2234-943X</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><p>Defects of the perineum may result from ablative procedures of different malignancies. The evolution of more radical excisional surgery techniques resulted in an increase in large defects of the perineum. The perineogenital region <italic>per se</italic>
has many different functions for urination, bowel evacuation, sexuality, and reproduction. Up-to-date individual and interdisciplinary surgical treatment concepts are necessary to provide optimum oncological as well as quality of life outcome. Not only the reconstructive method but also the timing of the reconstruction is crucial. In cases of postresectional exposition of e.g., pelvic or femoral vessels or intrapelvic and intra-abdominal organs, simultaneous flap procedure is mandatory. In particular, the reconstructive armamentarium of the plastic surgeon should include not only pedicled flaps but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. For intra-abdominally and/or pelvic tumors of the rectum, the anus, or the female reproductive system, which were resected through an abdominally and a sacrally surgical access, simultaneous vertical rectus abdominis myocutaneous (VRAM) flap reconstruction is recommendable. In terms of soft tissue sarcoma of the pelvic/caudal abdomen/proximal thigh region, two-stage reconstructions are possible. This review focuses on the treatment of perineum, genitals, and pelvic floor defects after resection of malignant tumors, giving a distinct overview of the different types of defects faced in this region and describing a number of reconstructive techniques, especially VRAM flap and pedicled flaps like antero-lateral thigh flap or free flaps. Finally, this review outlines some considerations concerning timing of the different operative steps.</p>
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</TEI>
<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Front Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Front Oncol</journal-id>
<journal-id journal-id-type="publisher-id">Front. Oncol.</journal-id>
<journal-title-group><journal-title>Frontiers in Oncology</journal-title>
</journal-title-group>
<issn pub-type="epub">2234-943X</issn>
<publisher><publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26500887</article-id>
<article-id pub-id-type="pmc">4597132</article-id>
<article-id pub-id-type="doi">10.3389/fonc.2015.00212</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Oncology</subject>
<subj-group><subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Plastic and Reconstructive Surgery in the Treatment of Oncological Perineal and Genital Defects</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Brodbeck</surname>
<given-names>Rebekka</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/277789"></uri>
</contrib>
<contrib contrib-type="author"><name><surname>Horch</surname>
<given-names>Raymund E.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/275798"></uri>
</contrib>
<contrib contrib-type="author"><name><surname>Arkudas</surname>
<given-names>Andreas</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/133615"></uri>
</contrib>
<contrib contrib-type="author"><name><surname>Beier</surname>
<given-names>Justus P.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
<uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/227750"></uri>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup>
<institution>Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuernberg</institution>
,<addr-line>Erlangen</addr-line>
,<country>Germany</country>
</aff>
<author-notes><fn fn-type="edited-by"><p>Edited by: Björn Behr, Ruhr University Bochum, Germany</p>
</fn>
<fn fn-type="edited-by"><p>Reviewed by: Ziv Radisavljevic, Brigham and Women’s Hospital, USA; Paul Willemsen, ZNA, Belgium</p>
</fn>
<corresp content-type="corresp" id="cor1">*Correspondence: Justus P. Beier, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuernberg, Erlangen, Germany, <email>justus.beier@uk-erlangen.de</email>
</corresp>
<fn fn-type="other" id="fn001"><p>Specialty section: This article was submitted to Surgical Oncology, a section of the journal Frontiers in Oncology</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>08</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>5</volume>
<elocation-id>212</elocation-id>
<history><date date-type="received"><day>18</day>
<month>6</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>17</day>
<month>9</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2015 Brodbeck, Horch, Arkudas and Beier.</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>Brodbeck, Horch, Arkudas and Beier</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract><p>Defects of the perineum may result from ablative procedures of different malignancies. The evolution of more radical excisional surgery techniques resulted in an increase in large defects of the perineum. The perineogenital region <italic>per se</italic>
has many different functions for urination, bowel evacuation, sexuality, and reproduction. Up-to-date individual and interdisciplinary surgical treatment concepts are necessary to provide optimum oncological as well as quality of life outcome. Not only the reconstructive method but also the timing of the reconstruction is crucial. In cases of postresectional exposition of e.g., pelvic or femoral vessels or intrapelvic and intra-abdominal organs, simultaneous flap procedure is mandatory. In particular, the reconstructive armamentarium of the plastic surgeon should include not only pedicled flaps but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. For intra-abdominally and/or pelvic tumors of the rectum, the anus, or the female reproductive system, which were resected through an abdominally and a sacrally surgical access, simultaneous vertical rectus abdominis myocutaneous (VRAM) flap reconstruction is recommendable. In terms of soft tissue sarcoma of the pelvic/caudal abdomen/proximal thigh region, two-stage reconstructions are possible. This review focuses on the treatment of perineum, genitals, and pelvic floor defects after resection of malignant tumors, giving a distinct overview of the different types of defects faced in this region and describing a number of reconstructive techniques, especially VRAM flap and pedicled flaps like antero-lateral thigh flap or free flaps. Finally, this review outlines some considerations concerning timing of the different operative steps.</p>
</abstract>
<kwd-group><kwd>interdisciplinary surgery</kwd>
<kwd>exenteration</kwd>
<kwd>VRAM flap</kwd>
<kwd>perineal reconstruction</kwd>
<kwd>microsurgical free flap</kwd>
</kwd-group>
<counts><fig-count count="4"></fig-count>
<table-count count="2"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="52"></ref-count>
<page-count count="8"></page-count>
<word-count count="5301"></word-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Allemagne</li>
</country>
</list>
<tree><country name="Allemagne"><noRegion><name sortKey="Brodbeck, Rebekka" sort="Brodbeck, Rebekka" uniqKey="Brodbeck R" first="Rebekka" last="Brodbeck">Rebekka Brodbeck</name>
</noRegion>
<name sortKey="Arkudas, Andreas" sort="Arkudas, Andreas" uniqKey="Arkudas A" first="Andreas" last="Arkudas">Andreas Arkudas</name>
<name sortKey="Beier, Justus P" sort="Beier, Justus P" uniqKey="Beier J" first="Justus P." last="Beier">Justus P. Beier</name>
<name sortKey="Horch, Raymund E" sort="Horch, Raymund E" uniqKey="Horch R" first="Raymund E." last="Horch">Raymund E. Horch</name>
</country>
</tree>
</affiliations>
</record>
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