Vertical rectus abdominis flap (VRAM) for perineal reconstruction following pelvic surgery: A systematic review

Abstract Background Venous thromboembolism (VTE) is a common postoperative complication associated with significant morbidity and mortality. The use of prophylactic heparin postoperatively reduces this risk, and the use of extended duration prophylaxis is becoming increasingly common. Malignancy and pelvic surgery both independently further increase the risk of postoperative VTE and patients undergoing major pelvic surgery for malignancy are at particularly high risk of VTE. However, the optimum duration of prophylaxis specifically in this population currently remains unclear. Methods We will conduct a systematic review of literature in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0.,2011) to evaluate current evidence of the effectiveness and safety of inpatient versus extended VTE prophylaxis with heparin (all forms) following major pelvic surgery for malignancy. We will search PubMed, EMBASE, and the Cochrane Library. Regarding safety, Food and Drug Administration (FDA), and Therapeutic Goods Administration (TGA) websites will be searched, including all levels of evidence. Results will be the postoperative timeframe in which a VTE event can be considered to have been provoked by the surgery, and the number of patients needed to treat with both inpatient and extended prophylaxis to prevent a VTE event in this timeframe, comparing these to determine if there is a significant benefit from extended prophylaxis. Discussion This systematic review will aim to identify the postoperative period in which patients undergoing major pelvic surgery for malignancy are at further increased risk of VTE as a result of their surgery and the optimum duration of heparin VTE prophylaxis with heparin to reduce this risk. Determining this will allow evidence-based recommendations to be made for the optimum duration of heparin VTE prophylaxis post major pelvic surgery for malignancy, leading to improved standards of care that are consistent between different providers and institutions. Systematic review registration In accordance with guidelines, our systematic review was submitted to PROSPERO for consideration of registration on 16/12/17 and was registered on 12/1/18 with the registration number CRD42018068961, and it was last updated on December 1, 2018.

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Transpelvic Rectus Abdominis Flap Reconstruction Following Abdominoperineal Resection

Updates in Surgery - Multimodal Treatment of Recurrent Pelvic Colorectal Cancer ◽

10.1007/978-88-470-5767-8_10 ◽

2016 ◽

pp. 103-135

Author(s):

Stefano Mori ◽

Cinzia Sassaroli ◽

Gianluca Di Monta ◽

Giovanni M. Romano

Keyword(s):

Abdominoperineal Resection ◽

Rectus Abdominis ◽

Flap Reconstruction ◽

Rectus Abdominis Flap

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Core Muscle Activity during Physical Fitness Exercises: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124306 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4306 ◽

Cited By ~ 3

Author(s):

José M. Oliva-Lozano ◽

José M. Muyor

Keyword(s):

Systematic Review ◽

Physical Fitness ◽

Rectus Abdominis ◽

Core Stability ◽

Erector Spinae ◽

Transversus Abdominis ◽

Emg Activity ◽

Electromyographic Activity ◽

Lumbar Multifidus ◽

External Oblique

The aim of this study was to systematically review the current literature on the electromyographic (EMG) activity of six core muscles (the rectus abdominis, the internal and external oblique, the transversus abdominis, the lumbar multifidus, and the erector spinae) during core physical fitness exercises in healthy adults. A systematic review of the literature was conducted on the Cochrane, EBSCO, PubMed, Scopus, and Web of Science electronic databases for studies from January 2012 to March 2020. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used. The inclusion criteria were as follows: (a) the full text available in English; (b) a cross-sectional or longitudinal (experimental or cohorts) study design; (c) the reporting of electromyographic activity as a percentage of maximum voluntary contraction (% MVIC), millivolts or microvolts; (d) an analysis of the rectus abdominis (RA), transversus abdominis (TA), lumbar multifidus (MUL), erector spinae (ES), and the internal (IO) or external oblique (EO); (e) an analysis of physical fitness exercises for core training; and (f) healthy adult participants. The main findings indicate that the greatest activity of the RA, EO, and ES muscles was found in free-weight exercises. The greatest IO activity was observed in core stability exercises, while traditional exercises showed the greatest MUL activation. However, a lack of research regarding TA activation during core physical fitness exercises was revealed, in addition to a lack of consistency between the studies when applying methods to measure EMG activity.

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