J S Bauzon1, N V Tran2, B R Hebert3, K L Mathis4. 1. Kirk Kerkorian School of Medicine at University of Nevada Las Vegas, Las Vegas, NV, USA. 2. Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA. 3. Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 1St Street SW, Rochester, MN, 55905, USA. 4. Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 1St Street SW, Rochester, MN, 55905, USA. mathis.kellie@mayo.edu.
Abstract
BACKGROUND: Pedicled seromuscular bowel flaps may serve as an alternative for pelvic floor reconstruction when conventional omental and muscular flaps are not an option in patients undergoing reoperative abdominopelvic surgery. The aim of this study was to evaluate a unique series of bowel seromuscular flaps used to obliterate intrapelvic defects. METHODS: We conducted a retrospective study on all patients in a single tertiary care institutional database who had undergone pelvic reconstruction with a seromuscular bowel flap from January 2006 to December 2018. The primary outcomes measured were the 30-day morbidity and mortality rates. RESULTS: Twelve patients (6 men 6 women, median age 56.5 years [range 33-77 years]) underwent reoperative abdominopelvic surgery requiring the use of a native small or large seromuscular bowel flap to obliterate pelvic defects. The indications for surgery included chronic infections, fistulizing Crohn's disease, and cancer. In all cases, no residual omentum was available and rectus abdominis muscle flaps were not feasible due to prior operative scars. Thirty-day morbidity occurred in 5 patients (42%), and included urine leak from ureteral injury, anastomotic leak, acute kidney injury, and superficial surgical site infection. No flaps became ischemic or required removal in the postoperative setting. No mortality was recorded. CONCLUSIONS: Bowel seromuscular flaps are a feasible and safe alternative for covering pelvic defects in patients who are undergoing reoperative surgery without the option to use traditional omental and muscular flaps.
BACKGROUND: Pedicled seromuscular bowel flaps may serve as an alternative for pelvic floor reconstruction when conventional omental and muscular flaps are not an option in patients undergoing reoperative abdominopelvic surgery. The aim of this study was to evaluate a unique series of bowel seromuscular flaps used to obliterate intrapelvic defects. METHODS: We conducted a retrospective study on all patients in a single tertiary care institutional database who had undergone pelvic reconstruction with a seromuscular bowel flap from January 2006 to December 2018. The primary outcomes measured were the 30-day morbidity and mortality rates. RESULTS: Twelve patients (6 men 6 women, median age 56.5 years [range 33-77 years]) underwent reoperative abdominopelvic surgery requiring the use of a native small or large seromuscular bowel flap to obliterate pelvic defects. The indications for surgery included chronic infections, fistulizing Crohn's disease, and cancer. In all cases, no residual omentum was available and rectus abdominis muscle flaps were not feasible due to prior operative scars. Thirty-day morbidity occurred in 5 patients (42%), and included urine leak from ureteral injury, anastomotic leak, acute kidney injury, and superficial surgical site infection. No flaps became ischemic or required removal in the postoperative setting. No mortality was recorded. CONCLUSIONS: Bowel seromuscular flaps are a feasible and safe alternative for covering pelvic defects in patients who are undergoing reoperative surgery without the option to use traditional omental and muscular flaps.
Authors: Rami W Radwan; Alethea M Tang; Rhiannon L Harries; Eleanor G Davies; Peter Drew; Martyn D Evans Journal: J Plast Reconstr Aesthet Surg Date: 2020-11-09 Impact factor: 2.740
Authors: David B Chessin; John Hartley; Alfred M Cohen; Madhu Mazumdar; Peter Cordeiro; Joseph Disa; Babek Mehrara; Bruce D Minsky; Philip Paty; Martin Weiser; W Douglas Wong; Jose G Guillem Journal: Ann Surg Oncol Date: 2005-02-03 Impact factor: 5.344