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- W2079427472 abstract "A major cause for morbidity following abdomino-perineal resection after pelvic radiotherapy for anorectal neoplasia is perineal wound complications, secondary to the large dead space created by the pelvic excision and the previously irradiated tissue. The use of the vertical rectus abdominis musculocutaneous (VRAM) flap for the reconstruction of large perineal defects provides effective tissue cover with a low incidence of wound complications, particularly after previous pelvic irradiation. 1 Chessin D.B. Hartley J. Cohen A.M. et al. Rectus flap reconstruction decreases perineal wound complications after pelvic chemoradiation and surgery: a cohort study. Ann Surg Oncol. 2005; 12: 104-110 Crossref PubMed Scopus (193) Google Scholar However, a common requirement prior to external beam pelvic radiation is the repair of any local hernias: when corrected laparoscopically this can inadvertently compromise the rectus abdominis deep inferior epigastric pedicle. 2 Epstein J. Arora A. Ellis H. Surface anatomy of the inferior epigastric artery in relation to laparoscopic injury. Clin Anat. 2004; 17: 400-408 Crossref PubMed Scopus (40) Google Scholar The management of a transverse rectus abdominis muscle (TRAM) flap for breast reconstruction after laparoscopic hernia repair – and vice versa – has been previously reported. 3 Johnson R.M. TRAM flap after laparoscopic hernia repair. Plast Reconstr Surg. 2005; 115: 1214-1215 Crossref PubMed Scopus (3) Google Scholar , 4 Shestak K.C. Fedele G.M. Restifo R.J. Treatment of difficult TRAM flap hernias using intraperitoneal synthetic mesh application. Plast Reconstr Surg. 2001; 107 ([discussion: 63–6]): 55-62 Crossref PubMed Scopus (25) Google Scholar We report the first case of fibrosis of the deep inferior epigastric pedicle due to prior laparoscopic inguinal hernia repair, in a patient who underwent VRAM reconstruction of an extensive perineal defect after tumour ablative surgery and previous radiotherapy." @default.
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- W2079427472 date "2009-06-01" @default.
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- W2079427472 title "Laparoscopic hernia repair compromising rectus abdominis muscle flap for perineal reconstruction despite initial patent vessels" @default.
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- W2079427472 doi "https://doi.org/10.1016/j.bjps.2008.11.013" @default.
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