Open AccessReconstruction of the pelvis and perineum with a free latissimus dorsi myocutaneous flap: a case report
Author(s) -
Ingrid Kieran,
Nicole R. Nugent,
M.Ó. Ríordáin,
John Kelly
Publication year - 2012
Publication title -
annals of the royal college of surgeons of england
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.39
H-Index - 63
eISSN - 1478-7083
pISSN - 0035-8843
DOI - 10.1308/003588412x13373405387537
Subject(s) - perineum , medicine , pelvic exenteration , surgery , colostomy , pelvis , pelvic cavity , abdominoperineal resection , stoma (medicine) , cancer , colorectal cancer
Reconstruction of the perineum and pelvic cavity in continuity is an uncommon and difficult challenge. This case describes a 66-year-old man who presented following recurrence of a Dukes' B rectosigmoid adenocarcinoma that had been treated nine years previously by anterior resection, 5-fluorouracil and radiotherapy. His recurrent disease was treated with radical pelvic exenteration with formation of an end colostomy and urinary ileal conduit. A post-operative pelvic collection necessitated incisional drainage via the perineum. This resulted in a perineal defect in continuity with the pelvic cavity, neither of which healed in spite of alternate day packing with antiseptic dressings. The perineum and cavity were reconstructed successfully with a microvascular transfer of the latissimus dorsi using the primary gracilis pedicle as recipient donor vessels.