Az anorectalis régió daganatai miatt végzett abdominoperinealis exstirpatiót (APE) követő perinealis sebgyógyulási zavarok komoly kihívást jelentenek a sebész számára. A sebgyógyulás körüli szövődmények csökkentését célzó sebészi lehetőségek közé tartozik a myocutan lebennyel való perinealis rekonstrukció is. Cikkünk irodalmi áttekintést nyújt az abdominoperinealis exstripatiót követő verticalis rectus abdominis myocutan (VRAM) lebennyel végzett perinealis rekonstrukciók eredményeiről. A kombinált neoadjuváns radio-kemoterápia elterjedése és a sebészi radikalitás kiterjesztésének lehetősége olyan kettős kockázattal jár, melynek csökkentésére hasznos lehetőség a colorectalis és a plasztikai sebész együttműködése.
1. NM Roth MR Sontag MF Kiani 1999 Early effects of ionizing radiation on the microvascular networks in normal tissue Radiat Res 151 270 7.
2. MJ Moore 1984 The effect of radiation on connective tissue Otolaryngol Clin North Am 17 389 99.
3. KM Bullard JL Trudel NN Baxter DA Rothenberger 2005 Primary perineal wound closure after preoperative radiotherapy and abdomioperineal resection has a high incidence of wound failure Dis Colon Rectum 48 438 43.
4. MA Chadwick D Vieten E Pettitt AR Dixon AM Roe 2006 Short course preoperative radiotherapy is the single most important risk factor for perineal wound complications after abdominoperineal excision of the rectum Colorectal Dis 8 756 61.
5. A Nissan JG Guillem PB Paty W Douglas Wong B Minsky L Saltz AM Cohen 2001 Abdominoperineal resection for rectal cancer at a speciality center Dis Colon Rectum 44 27 35.
6. L Rosen MC Veidenheimer JA Coller ML Corman 1982 Mortality, morbidity and patterns of reccurence after abdominoperineal resection for cancer of the rectum Dis Colon Rectum 25 202 8.
7. CW Pollard S Nivatvongs A Rojanasakul DM Ilstrup 1994 Carcinoma of the rectum. Profiles of intraoperative and early postoperative complications Dis Colon Rectum 37 866 74.
8. DA Rothenberger WD Wong 1992 Abdominoperineal resection for adenocarcinoma of the low rectum World J Surg 16 478 85.
9. JB So MT Palmer PC Shellito 1997 Postoperative perineal hernia Dis Colon Rectum 40 954 7.
10. HS Shukla LE Hughes 1984 The rectus abdominis flap for perineal wounds Ann R Coll Surg Engl 66 337 9.
11. JB McCraw FM Massey KD Shanklin CE Horton 1976 Vaginal reconstruction with gracilis myocutaneous flaps Plast Reconstr Surg 58 176 83.
12. A Shaw JW Futrell 1978 Cure of chronic perineal sinus with gluteus maximus flap Surg Gynecol Obstet 147 417 20.
13. EW Buchel S Finical C Johson 2004 Pelvic reconstruction using vertical rectus abdominis musculocutaneous flaps Ann Plast Surg 52 22 6.
14. DN D'Souza M Pera H Nelson SJ Finical NV Tran 2003 Vaginal reconstruction following resection of primary locally advanced and recurrent colorectal malignancies Arch Surg 138 1340 3.
15. R Bakx JJ van Lanschot FA Zoetmulder 2004 Inferiorly based rectus abdominis myocutaneous flaps in surgical oncology: indications, technique and experience in 37 patients J Surg Oncol 85 93 7.
16. G Houvenaeghel L Ghouti V Moutardier M Buttarelli B Lelong JR Delpero 2005 Rectus abdominis myocutaneous flap in radical oncopelvic surgery: a safe and useful procedure Eur J Surg Oncol 31 1185 90.
17. AK Jain AJ DeFranzo MW Marks BW Loggie S Lentz 1997 Reconstruction of pelvic exenterative wounds with transpelvic rectus abdominis flaps: a case series Ann Plast Surg 38 115 22.
18. SS Kroll R Pollock Jm Jessup D Ota 1989 Transpelvic rectus abdominis flap reconstruction of defects following abdominal.perineal resection Am Surg 55 632 7.
19. SJ Loessin NB Meland RM Devine BG Wolff H Nelson H Zincke 1995 Management of sacral and perineal defects following abdominoperineal resection and radiation with transpelvic muscle flaps Dis Colon Rectum 38 940 5.
20. E McAllister K Wells M Chaet J Norman W Cruse 1994 Perineal reconstruction after surgical extirpation of pelvic malignancies using the transpelvic transverse rectus abdominal myocutaneous flap Ann Surg Oncol 1 164 8.
21. GB Melton PB Paty PJ Boland et al.2006 Sacral resection for recurrent reactal cancer: analysis of morbidity and treatment results Dis Colon Rectum 49 1099 107.
22. SW Bell N Dehni M Chaouat JC Lifante R Parc E Tiret 2005 Primary rectus abdominis myocutaneous flap for repair of perineal and vaginal defects after extended abdominoperineal resection Br J Surg 92 482 6.
23. WG De Haas MJ Miller WJ Temple SS Kroll MA Schusterman GP Reece JM Skibber 1995 Perineal wound closure with the rectus abdominis musculocutaneous flap after tumor ablation Ann Surg Oncol 2 400 6.
24. MW Erdmann N Waterhouse 1995 The transpelvic rectus abdominis flap: its use in the reconstruction of extensive perineal defects Ann R Coll Surg Engl 77 229 32.
25. CE Butler AO Gundeslioglu MA Rodriguez Bigas 2008 Outcomes of immediate vertical rectus abdominis myocutaneous flap reconstruction for irradiated abdominoperineal resection defects J Am Coll Surg 206 694 703.
26. DB Chessin J Hartley AM Cohen et al.2005 Rectus flap reconstruction decreases perineal wound complications after pelvic chemoradiation and surgery: a cohort study Ann Surg Oncol 12 104 10.
27. FT Ferenschild M Vermaas SO Hofer C Verhoef AM Eggermont JH de Wilt 2005 Salvage abdominoperineal resection and perineal wound healing in local recurrent or persistent anal cancer World J Surg 29 1452 7.
28. E Radice H Nelson S Mercill R Farouk P Petty L Gunderson 1999 Primary myocutaneous flap closure following resection of locally advanced pelvic malignancies Br J Surg 86 349 54.
29. TM Tei T Stolzenburg S Buntzen S Laurberg H Kjeldsen 2003 Use of transpelvic rectus abdominis musculocutaneous flap for anal cancer salvage surgery Br J Surg 90 575 80.
30. AI Skene DT Gault CR Woodhouse NM Breach JM Thomas 1990 Perineal, vulval and vaginoperineal reconstruction using the rectus abdominis myocutaneous flap BR J Surg 77 635 7.
31. GI Taylor R Corlett JB Boyd 1983 The extended deep inferior epigastric flap: a clinical technique Plast Reconstr Surg 72 751 65.
32. CJ Gabka P Benhaim SJ Mathes H Scheuenstuhl A Chan KK Fu TK Hunt 1995 An experimental model to determine the effect of irradiated tissue on neutrophil function Plast Reconstr Surg 96 1676 88.
33. S Delanian M Martin A Bravard C Luccioni JL Lefaix 1998 Abnormal phenotype of cultured fibroblasts in human skin with chronic radiotherapy damage Radiother Oncol 47 255 61.
34. P Juni F Holenstein J Sterne C Bartlett M Egger 2002 Direction and impact of language bias in meta-analyses of controlled trials: empirical study Int J Epidemiol 31 115 23.
35. PJ Nilsson 2006 Omentoplasty in abdominoperineal resection: a review of the literature using a systematic approach Dis Colon Rectum 49 1354 61.
36. YL Klaver SW Nienhuijs GA Nieuwenhuijzen HJ Rutten IH de Hingh 2008 Omentoplasty in rectal cancer surgery prolongs post-operative ileus Int J Colorectal Dis 23 165 9.
37. DW Becker Jr. FM Massey JB McCraw 1979 Musculocutaneous falps in reconstructive pelvic surgery Obstet Gynecol 54 178 83.
38. T Holm A Ljung T Haggmark G Jurell J Lagergren 2007 Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer Br J Surg 94 232 8.