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Perineal reconstruction

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https://www.readbyqxmd.com/read/29238441/reconstruction-of-an-irradiated-perineal-wound-with-a-superior-gluteal-artery-perforator-flap
#1
Yangshu L Pan, Albert H Chao
No abstract text is available yet for this article.
2017: Eplasty
https://www.readbyqxmd.com/read/29237218/-cylindric-abdominoperineal-rectum-exstirpation-with-partial-vulvar-and-vaginal-resection-as-well-as-perineal-and-vaginal-defect-reconstruction-by-a-vertical-rectus-abdominis-myocutaneous-vram-flap
#2
Christian Krautz, Klaus Weber, Roland Croner, Axel Denz, Matthias Maak, Raymund E Horch, Robert Grützmann
Introduction Patients with low rectal cancer or anal cancer undergoing abdominoperineal excision (APE) benefit from extended surgery and the subsequent avoidance of surgical "waisting" at the level of the puborectalis muscle. The method of cylindrical APE was introduced by T. Holm and led to a reduction of intraoperative perforations and involvement of circumferential resection margins, and subsequently reduced the risk of local recurrence. The use of myocutaneous flaps reduces perineal wound complications, which occur in up to 60% of patients with primary closure of perineal defects, especially following neoadjuvant radiochemotherapy...
December 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29204168/pre-plan-technique-feasibility-in-multi-interstitial-endocavitary-perineal-gynecological-brachytherapy
#3
Silvia Rodriguez, Antonio Otal, Jose Richart, Jose Perez-Calatayud, Manuel Santos
Purpose: To present the implementation of a magnetic resonance imaging (MRI) pre-planning technique in multi-interstitial perineal and endocavitary gynecological brachytherapy. Material and methods: We used a new fully MRI-compatible applicator that is capable to engage titanium needles, and an intrauterine tandem, developed in our department for the treatment of gynecological cervical cancer patients. This applicator is an attempt to combine the technical advantages of the Martinez universal perineal interstitial template (MUPIT) with the improvement in dose distribution by adding an intrauterine probe with the imaging advantages of MRI-based brachytherapy, thus preserving the stability, geometry, and robustness of the implant, avoiding possible errors of free-hand needle placement...
October 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29198998/surgical-approaches-and-long-term-outcomes-in-adults-with-complex-re-operative-hypospadias-repair
#4
Christopher D Morrison, Davide P Cinà, Christopher M Gonzalez, Matthias D Hofer
PURPOSE: Patients with failed hypospadias repair are a challenging population for both pediatric and reconstructive urologists. In this study, we describe our long-term outcomes and factors associated with complications in repeat hypospadias repairs. MATERIAL AND METHODS: A retrospective review of 32 adult patients with a history of hypospadias repair who required subsequent urethroplasty between 2002 and 2012 was performed. Presenting complaint, past medical and surgical history, demographic data, surgical approach, intraoperative findings, and complications were collected and analyzed...
November 30, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29175024/y-type-urethral-duplication-with-rectal-implantation-of-the-urethra-which-is-the-best-approach
#5
Antonio Macedo, Sérgio Leite Ottoni, Marcela Leal da Cruz, Jorge Antonio Pompermaier, Maria Isabel S Silva, Riberto Liguori, Gilmar Garrone
INTRODUCTION: Y-type urethral duplication describes the condition in which a functional urethra is implanted in the rectum, and there is also a dysplastic topic urethra which produces mostly urinary dribbling. These patients are at risk of urinary tract complications and UTI. We aimed to present the surgical steps of a case treated by ASTRA approach in which we separated the urethra from the rectum and created a perineal urethrostomy. MATERIAL AND METHODS: We treated a 5-month-old boy with Y-type (IIA-2) urethral duplication, in whom the orthotopic urethra was patent just in the penile segment...
November 10, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29174477/the-effect-of-hip-reconstruction-on-gross-motor-function-levels-in-children-with-cerebral-palsy
#6
Mutlu Cobanoglu, Emre Cullu, Imran Omurlu
OBJECTIVE: The aim of this study was to determine whether the hip reconstruction has an effect on gross motor function classification system (GMFCS) levels in patients with hip instability in cerebral palsy (CP). METHODS: A total of 45 hips of 30 patients (mean age: 8.7 (4-17) years) with CP operated due to hip instability with a minimum of 2 years of follow-up were included into the study. Migration index was used for classification of the severity of hip instability...
November 23, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29166313/the-perineal-turnover-perforator-flap-a-new-and-simple-technique-for-perineal-reconstruction-after-extralevator-abdominoperineal-excision
#7
Maria Chasapi, Mohamed Maher, Peter Mitchell, Milind Dalal
BACKGROUND: Extralevator abdominoperineal excision (ELAPE) is increasingly used to treat locally advanced low rectal cancer as it has been related to superior oncological outcomes than traditional abdominoperineal excision.However, ELAPE also has been associated with high perineal wound morbidity rates as it creates a larger perineal cavity than standard abdominoperineal excision. This greater defect, along with the effects of preoperative chemoradiation on wound healing, makes uneventful perineal reconstruction post-ELAPE a real challenge for the plastic surgeon...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29158171/pubo-urethral-stump-angle-measured-on-preoperative-mri-predicts-urethroplasty-type-for-pelvic-fracture-urethral-injury-repair
#8
Akio Horiguchi, Hiromi Edo, Shigeyoshi Soga, Masayuki Shinchi, Ayako Masunaga, Keiichi Ito, Tomohiko Asano, Hiroshi Shinmoto, Ryuichi Azuma
OBJECTIVES: To examine whether the type of delayed urethroplasty required for pelvic fracture urethral injury (PFUI), which is not easily predicted from conventional urethrography findings, can be predicted from preoperative magnetic resonance imaging (MRI) results. PATIENTS AND METHODS: Records of 74 male patients with PFUI who underwent MRI of the pelvis at least 3 months after injury and, subsequently, delayed anastomotic urethroplasty were retrospectively analyzed...
November 17, 2017: Urology
https://www.readbyqxmd.com/read/29135409/double-inlay-plus-ventral-onlay-buccal-mucosa-graft-for-simultaneous-penile-and-bulbar-urethral-stricture
#9
Luciano A Favorito, Paulo P Conte, Ulisses G Sobrinho, Rodrigo G Martins, Tomas Accioly
OBJECTIVES: Buccal mucosa grafts and fascio-cutaneous flaps are frequently used in long anterior urethral strictures (1). The inlay and onlay buccal mucosa grafts are easier to perform, do not need urethral mobilization and generally have good long-term results (2-4). In the present video, we present a case where we used a double buccal mucosa graft technique in a simultaneous penile and bulbar urethral stricture. MATERIALS AND METHODS: A 54 year-old male patient was submitted to appendectomy where a urethral catheter was used for two days in May 2015...
November 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29130235/-a-meta-analysis-on-risk-factors-of-postoperative-perineal-wound-complications-after-abdominoperineal-resection-for-rectal-cancer
#10
Senqi Lu, Xiaofeng Chang, Xiaodong Yang, Decai Yu, Qigen Huang, Feng Wang
OBJECTIVE: To investigate the risk factors of postoperative perineal wound complications after abdominoperineal resection for rectal cancer. METHODS: The databases of Medline, Embase, Web of Science, Ovid, Cochrane Library, CBM, CNKI, VIP and WANFANG were searched for the studies of abdominoperineal resection up to October 2016. The quality of the included studies was assessed by using "Cochrane collaboration's tool for assessing risk of bias" and "the Newcastle-Ottawa Scale"...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29118550/-horrendoplasty-a-case-of-total-perineal-destruction-by-agricultural-implement
#11
Pedro Simoes de Oliveira, Tiago Ribeiro de Oliveira, David Martinho, Francisco Martins
Although posterior urethral injury occurs almost always in association with pelvic fracture, it may result from severe trauma to the perineum with its associated potential lethality and severe morbidity. Early primary endoscopic realignment over a urethral catheter can be attempted, although an immediate suprapubic tube placement remains the standard of care. Definitive treatment consists of elective open posterior anastomotic urethroplasty through a perineal approach. The authors present a 53-year-old man who sustained total, massive perineal destruction resulting from work accident with an agricultural implement...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29107432/-reconstruction-of-abdo-perineal-resection-by-taylor-flap-about-68-patients
#12
D Boccara, K SerroR, J Lefevre, M Mimoun, M Chaouat
PURPOSES: Healing after abdomino-perineal resection is often difficult, especially in patients who have undergone radiation therapy. Vaginal reconstruction is also an important issue for the women who undergo this surgery. We describe and analyze here our series of perineal reconstructions with modified Taylor flaps. Between 2010 and 2016, 68 patients (52 women, 16 men) with cancer of the anal canal (53), adenocarcinoma of the lower rectum (9), or other malignant neoplasms of the perineum underwent reconstruction with a rectus abdominis myocutaneous (RAM) flap with an inferior pedicle and an oblique skin paddle...
October 26, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29100881/pedicled-posteromedial-thigh-ppmt-perforator-flap-and-its-application-in-loco-regional-soft-tissue-reconstructions
#13
Mario F Scaglioni, Alberto Franchi, Pietro Giovanoli
INTRODUCTION: The posteromedial thigh (PMT) perforator flap is a valuable reconstructive option. In its pedicled form, the experience is currently limited to a few case reports. The purpose of this article is to describe various clinical applications of the pedicled posteromedial thigh (pPMT) flap for reconstruction of loco-regional soft tissue defects. PATIENTS AND METHODS: From 2014 to 2016, 15 patients underwent reconstruction with 15 pPMT flaps. The locations of the defects included the inguinal region (4 cases), the perineal and genital region (3 cases), the proximal and distal medial thigh (3 and 2 cases, respectively), and the popliteal fossa (3 cases)...
October 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29095185/immediate-perineal-reconstruction-after-extralevatory-abdominoperineal-excision-buried-desepidermised-fasciocutaneous-v-y-advancement-flap
#14
Özay Özkaya, Ayça Ergan Şahin, İlker Üsçetin, Hakan Güven, Fazil Sağlam
BACKGROUND: According to National Cancer Institute, there are approximately 39,800 rectal cancer cases per year, 25% of which will need an abdominoperineal resection (APR). The key to avoid most of the complications related to pelvic defect that occurs after APR is choosing an appropriate reconstruction option for perineum. This study aims to introduce an easily applicable flap option for closure to address postoperative pelvic defect in low rectal cancer. METHODS: This is a retrospective evaluation of 9 patients who have undergone perineal reconstruction for pelvic defects after extralevatory abdominoperineal excision with rectal cancer between 2014 and 2016...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29071395/-25%C3%A2-years-of-integral-theory-by-petros-what-remains-and-what-s-next
#15
REVIEW
A Gunnemann, B Liedl, K Goeschen
BACKGROUND: The Integral Theory (IT) states that urinary stress and urge symptoms mainly arise from lax suspensory ligaments, which are a consequence of altered collagen/elastin. Four important muscle groups (pubococcygeal muscle, levatorplate, longitudinal muscle of the anus, and the puborectalis muscle) are only able to guarantee the opening and closure mechanism of the bladder, the urethra and the anal tube if the suspensory ligaments are intact. The first practical application of the IT was the repair of the pubourethral ligament (PUL) known as tension-free vaginal tape (TVT)...
October 25, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29062664/combined-gluteus-and-pudendal-thigh-flap-reconstruction-of-vaginal-defects-following-robotic-abdominoperineal-resection
#16
Kasandra R Dassoulas, Traci L Hedrick, Chris A Campbell
Low-lying rectal cancers are being treated more frequently with robotic-assisted abdominoperineal resection, obviating the need for laparotomy and the ability to raise vertical rectus abdominis musculocutaneous flaps. For female patients, posterior vaginectomy often accompanies the resection. Combined pudendal thigh flaps as an extension of bilateral gluteus advancement flaps allow for posterior vaginal resurfacing with thin pliable fasciocutaneous flaps, which rest on the gluteal flap soft-tissue bulk that obliterates the pelvic dead space...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29046109/use-of-the-profunda-artery-perforator-flap-in-vulvo-perineal-reconstruction
#17
S S Jing, B Winter-Roach, D Kosutic
No abstract text is available yet for this article.
October 19, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28969732/delayed-reconstruction-of-a-traumatic-cloaca-following-obstetric-anal-sphincter-rupture
#18
Ali Ezer, Alper Parlakgumus
Permanent communication between the rectum and the vagina along with full thickness of anal sphincter faults can be a result of an unsuccessful primary repair of fourth degree obstetric trauma. This results into complete fecal incontinence and impaired quality of life. Anterior overlapping sphincteroplasty can be chosen as a method of treatment for fecal incontinence due to obstetric injuries. However, large perineal body reconstructions are generally pretty challenging tasks for surgeons. What we will describe here for the repair of a traumatic cloaca, occurred 23 years ago during vaginal delivery, is the use of a transpositional flap following overlapping sphincteroplasty...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28967431/resection-of-the-inferior-pubic-ramus-to-completely-remove-locally-advance-adenoid-cystic-carcinoma-of-bartholin-s-gland
#19
Hidetaka Nomura, Minoru Nagashima, Yoichi Aoki, Nobuhiro Takeshima
OBJECTIVE: Some sections of the pelvic bone can be removed without severe loss of function, including the inferior pubic ramus. Here we report a technique for the complete resection of locally advanced adenoid cystic carcinoma (ACC) of the Bartholin's gland that had invaded the obturator muscle and inferior pubic ramus. METHODS: We chose to operate because there was little evidence of definitive radiotherapy for ACC of the vulva. As preoperative imaging did not suggest lymph node metastasis, we omitted lymphadenectomy...
September 26, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28948372/comparative-anatomy-on-3-d-mri-of-the-urogenital-sinus-and-the-periurethral-area-before-and-during-the-second-stage-of-labor-during-childbirth
#20
Jean-Christophe Maran, Lucie Cassagnes, Vincent Delmas, Dominique Musset, René Frydman, Gérard Mage, Michel Canis, Louis Boyer, Olivier Ami
PURPOSE OF THE STUDY: To describe the observable MRI changes in the urogenital sinus during the second stage of labor and delivery by comparing the changes in the positions of the anatomical structures of the maternal perineum using MRI-based vector 3-D models. MATERIALS AND METHODS: Seven pregnant women underwent 3-D MRI sequences using a Philips 1 T Panorama open MRI during the pre-labor period and during the second stage of labor. A 3-D vector reconstruction platform (BABYPROGRESS, France) enabled the transformation of volumes of 2-D images into finite element meshes...
September 26, 2017: Surgical and Radiologic Anatomy: SRA
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