Vulvo-vaginal reconstruction after radical excision for treatment of vulvar cancer: Evaluation of feasibility and morbidity of different surgical techniques

Donato, Violante Di; Bracchi, Carlotta; Cigna, Emanuele; Domenici, Lavinia; Musella, Angela; Giannini, Andrea; Lecce, Francesca; Marchetti, Cláudia; Panici, Pierluigi Benedetti

doi:10.1016/j.suronc.2017.10.002

Cited by 48 publications

(48 citation statements)

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“…The authors argue that, although reconstruction may allow for better achievement of tumor control, it is important to consider comorbidities and optimize wound healing potential preoperatively. 41 In another prospective review of 114 gluteal fold flaps after vulvoperineal resection, the rate of major complications was 11% and the minor complication rate was 17%. Previous radiation and a rotational flap rather than advancement flap were found to be risk factors for complications.…”

Section: Discussionmentioning

confidence: 98%

Trends and Complications of Vulvar Reconstruction After Vulvectomy: A Study of a Nationwide Cohort

Martin

Stewart

Girithara-Gopalan

et al. 2018

Int J Gynecol Cancer

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Section: Discussionmentioning

confidence: 98%

Trends and Complications of Vulvar Reconstruction After Vulvectomy: A Study of a Nationwide Cohort

Martin

Stewart

Girithara-Gopalan

et al. 2018

Int J Gynecol Cancer

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“…(Di Donato et al, 2017). They included 24 studies and found the majority of flaps were either advancement flaps or transpositional flaps with similar complication rates: 26.7% vs 22.3%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 11 advancement flap studies they included, only 165 patients were included, further solidifying the need for further research related to this technique. (Di Donato et al, 2017). Finally, a retrospective single institution series looked at 234 patients undergoing a V—Y advancement flap compared to 128 undergoing a lotus petal flap (LPF) after demolitive surgery for vulvar malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…(Di Donato et al, 2017; Confalonieri et al, 2017). Both have low complication rates however expertise in surgical dissection of the vessels is necessary for transposition flaps.…”

Section: Discussionmentioning

confidence: 99%

“…Moderate to large sized defects often require an advancement flap as less tension is placed on the wound. (Di Donato et al, 2017)…”

Section: Discussionmentioning

confidence: 99%

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Utilizing V Y fasciocutaneous advancement flaps for vulvar reconstruction

Hand

Maas

Baka

et al. 2018

Gynecologic Oncology Reports

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ObjectivesWe aimed to analyze the outcomes of patients who underwent vulvectomy with subsequent V—Y fasciocutaneous flap reconstruction.MethodsAll medical records of all patients who underwent vulvectomies with V—Y fasciocutaneous flap reconstruction from January 2007 to June 2016 were retrospectively reviewed. Patient clinical and surgical data, demographics, and outcomes were abstracted.ResultsOf the 27 patients, 42 flaps were transferred. A simple vulvectomy was performed in 8 (30%) patients, partial radical vulvectomy in 15 (56%), and radical vulvectomy in 4 (15%). The median area of defect was 30 cm2. Minor wound separations occurred in 9 patients (33%). Infectious complications occurred in 4 patients (15%); this included urinary tract infections in 2 (50%), postoperative fevers in 2 (50%), and sepsis in 1 (25%) patient with a UTI. There were no instances of flap necrosis, wound dehiscence, or wound infections. Black race was more likely to be associated with an infectious complication with 3 (75%) patients, compared to white race with 1 (4%) patient (p < .01). The presence of diabetes was more likely to be associated with an infectious complication in 2 (67%) patients, compared to 1 (4%) in non-diabetic patients (p < .01). No other significant association was found during analysis of demographics, medical comorbidities, vulvar pathology, or surgical factors affecting V—Y fasciocutaneous flap infectious complications or minor wound separations.ConclusionsThe use of a V—Y fasciocutaneous advancement flap for vulvar reconstruction is safe and associated with mostly minor complications. Infectious complications were more frequently associated with diabetes, black race, and HIV.

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Outcomes Following Exenteration for Gynecological Neoplasms

Kannisto

Lydrup

2021

Surgical Management of Advanced Pelvic Cancer

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Vulvo-vaginal reconstruction after radical excision for treatment of vulvar cancer: Evaluation of feasibility and morbidity of different surgical techniques

Cited by 48 publications

References 50 publications

Trends and Complications of Vulvar Reconstruction After Vulvectomy: A Study of a Nationwide Cohort

Trends and Complications of Vulvar Reconstruction After Vulvectomy: A Study of a Nationwide Cohort

Utilizing V Y fasciocutaneous advancement flaps for vulvar reconstruction

Outcomes Following Exenteration for Gynecological Neoplasms

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