Publication details

Pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after pelvic exenterations

Authors

CIBULA D. ZIKAN M. FISCHEROVA D. KOCIAN R. GERMANOVA A. BURGETOVA A. DUŠEK Ladislav FARTÁKOVÁ Z. SCHNEIDEROVÁ M. NEMEJCOVÁ K. SLAMA J.

Year of publication 2017
Type Article in Periodical
Magazine / Source Gynecologic Oncology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1016/j.ygyno.2017.01.014
Field Oncology and hematology
Keywords Empty pelvic syndrome; Muscular flap; Pelvic exenteration; Pelvic floor reconstruction
Description Objective To describe the technique and report experiences with pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after extensive pelvic procedures. Methods Surgical technique of MRAM harvest and transposition is carefully described. The patients in whom pelvic floor reconstruction with MRAM after either infralevator pelvic exenteration and/or extended lateral pelvic sidewall excision was carried out were enrolled into the study (MRAM group, n = 16). Surgical data, post-operative morbidity, and disease status were retrospectively assessed. The results were compared with a historical cohort of patients, in whom an exenterative procedure without pelvic floor reconstruction was performed at the same institution (control group, n = 24). Results Both groups were balanced in age, BMI, tumor types, and previous treatment. Substantially less patients from the MRAM group required reoperation within 60 days of the surgery (25% vs. 50%) which was due to much lower rate of complications potentially related to empty pelvis syndrome (1 vs. 7 reoperations) (p = 0.114).

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