Fasciocutaneous Lotus Petal Flap for Perineal Wound Reconstruction after Extralevator Abdominoperineal Excision: Application for Reconstruction of the Pelvic Floor and Creation of a Neovagina

Abstract

Reconstruction of the pelvic floor after ELAPE using the fasciocutaneous lotus petal flap has limited major complications, but still with a high incidence of minor wound complications. This retrospective cohort study shows limited consequences on form and function.

A Systematic Review and Meta-analysis on Omentoplasty for the Management of Abdominoperineal Defects in Patients Treated for Cancer

“…2,4,6,9,10,[23][24][25][26][27][28][29] In the OP group, the overall weighted mean proportion of ileus was 7.8% (95% CI 4.2%-14.2%), 2,4,9,10,[23][24][25][26]29 and 3.8% (95% CI 2.3%-6.2%) required reoperation for ileus. 2,4,6,25,[27][28][29] Considering 8 comparative studies, overall incidence of ileus was not significantly different with or without OP (RR 0.90; 95% CI 0.62-1.31; I 2 ¼ 0%), 2,4,9,23,24,26 nor the proportion of ileus requiring reoperation (RR 1.19; 95% CI 0.58-2.44; I 2 ¼ 0%). 2,4,6,28 Perineal Hernia…”

“…After contacting the authors, individual patient data were provided in six [4][5][6][22][23][24] and aggregate data in four. [25][26][27][28] An additional of 4 studies with full text of the original paper only were included. 9,10,29,30 Eleven studies without separate data for OP, [31][32][33][34][35][36][37][38][39][40][41] and 1 study that eventually appeared to have included only 1 patient with OP 42 were excluded.…”

“…Twelve studies recorded the incidence of presacral abscess formation. [4][5][6]10,[22][23][24][25][26][27][28][29] The overall weighted mean proportion of presacral abscess formation following OP was 8.7% (95% CI 6.1%-12.3%). Considering 9 comparative studies, 4 -6,10,22-24,26,28 presacral abscesses similarly occurred after OP and non-OP (RR 1.11; 95% CI 0.79-1.56; I 2 ¼ 0%) ( Fig.…”

“…Eight studies recorded the primary perineal wound healing. 2,4,[24][25][26][27][28][29] The overall weighted mean cumulative proportion of complicated wound healing at 30 days following OP was 50.6% (95% CI 35.5%-65.6%). In 5 comparative studies, 2,4,24,26,28 the rate of complicated wound healing within 30 days was not significantly different after OP and non-OP (RR 1.30; 95% CI 0.92-1.82; I 2 ¼ 74%).…”

Quality of Life and Sexual Functioning After Vulvar Reconstruction With the Lotus Petal Flap

“…6 In our center, the fasciocutaneous lotus petal flap procedure has been used since 2005 for vulvar and perineal reconstruction. 7 The lotus petal flap, first described by Yii and Niranjan, 8 uses local tissue from an area where scars can be easily hidden in the fold of the buttocks or groins. The lotus petal flap technique is useful in numerous situations.…”