scholarly journals PERINEAL REPAIR AFTER ABDOMINOPERINEAL EXCISION WITH RECTUS ABDOMINIS MYOCUTANEOUS FLAP

Author(s):  
Elsa D’ANNUNZIO ◽  
Alain VALVERDE ◽  
Renato Micelli LUPINACCI

ABSTRACT Background: Abdominoperineal excision of the rectum (APR) remains the only potential curative treatment for very low rectal adenocarcinoma and squamous cell carcinoma of the anus. Yet, it implies a significant perineal exenteration and has set the attention on the perineal reconstruction. Aim: To present technique used in one case of APR for anal cancer, with resection of the vaginal posterior wall with large perineal defect which has called for the necessity of a flap for reconstruction Method: To cover the large perineal defect and reconstruct the posterior vaginal wall was perform a standardized and reproducible surgical technique using oblique rectus abdominis myocutaneous (ORAM) flap. The overlying skin of this flap is thick and well vascularized by both superficial branches and perforators of the superior epigastric artery and the deep inferior epigastric artery which serves as the vascular pedicle for the ORAM flap. Results: This procedure was applied in a 65-year-old woman with recurrent squamous cell carcinoma of the anus infiltrating the posterior wall of the vagina. Was performed an APR with en-bloc resection of the vaginal posterior wall in order to achieve tumor-free margins. Postoperative course was uneventful and she was discharged home at postoperative day 9. Final pathological report confirmed the oncological adequacy of the procedure (R0) and showed a rypT4N0 lesion. Conclusion: Flap reconstruction is an effective way to cover the perineal wound reducing both perineal complication rate and wound healing delay. The ORAM is particularly interesting for female whose tumors require resection and subsequent reconstruction of the posterior wall of the vagina.

1995 ◽  
Vol 59 (1) ◽  
pp. 159-161 ◽  
Author(s):  
J.W. Carlson ◽  
A.K. Saltzman ◽  
J.R. Carter ◽  
E.M. Hartenbach ◽  
P.R. Johnson ◽  
...  

2016 ◽  
Vol 15 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Robert A. Franklin ◽  
Smith Giri ◽  
Poojitha Valasareddy ◽  
Lindsey T. Lands ◽  
Mike G. Martin

2007 ◽  
Vol 99 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Oliver J. Kayes ◽  
Charles A. Durrant ◽  
David Ralph ◽  
David Floyd ◽  
Simon Withey ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Triantafyllia Koletsa ◽  
Georgios Petrakis ◽  
Georgia Karayannopoulou ◽  
Dimitrios Pappas ◽  
Konstantinos Markou ◽  
...  

Synchronous malignancy of squamous cell carcinoma and malignant lymphoma in the head and neck region is extremely rare. Nasopharyngeal carcinoma is a nonlymphomatous, squamous cell carcinoma that occurs in the nasopharyngeal epithelium. Reported herein is a unique case of nasopharyngeal carcinoma occurring simultaneously with MALT-type lymphoma in an 83-year-old woman, who complained of deglutition dysfunction. Endoscopic examination of respective organs revealed a submucosal tumour on the posterior wall of pharynx. Biopsy of the hypopharynx was taken and sent for histological examination, which revealed two different neoplasms. Immunohistochemical and molecular analysis confirmed the diagnosis of nasopharyngeal carcinoma coexisting with a MALT-type lymphoma.


2014 ◽  
Vol 29 (2) ◽  
pp. 157
Author(s):  
Jung Ik Park ◽  
Ung Seok Yang ◽  
Sung Won Moon ◽  
Oun Ouk Nam ◽  
Hyo Jong Kim ◽  
...  

2020 ◽  
Author(s):  
Yange Zhang ◽  
Wei Li

Abstract Background: Previous studies have not demonstrated an independent association of age and tumor grade. In this study, we aimed to explore the relationship between age and tumor grade (differentiation) in patients with digestive tumors.Methods: Surveillance, Epidemiology and End Results (SEER) 18 registry database for 1973 through 2015 was retrieved for the present study. Both piecewise and non-piecewise linear regression model were utilized to examine the relationship between age and tumor grade. Results: The present study included a total of 938,145 patients with 13 types of primary malignancies of the digestive system. In non-piecewise regression analyses, older age was associated with higher tumor grades in patients with esophageal squamous cell carcinoma (P < 0.0001) and anal squamous cell carcinoma (P < 0.0001). In contrast, older age was related to lower tumor grades in patients with esophageal adenocarcinoma (P = 0.0177), gastric adenocarcinoma (P < 0.0001), pancreatic adenocarcinoma (P < 0.0001) and rectal adenocarcinoma (P < 0.0001). In piecewise regression analyses, positive associations of age and tumor grade were only observed in specific age groups in some types of tumor, e.g., anal adenocarcinoma (> 66 years), gallbladder adenocarcinoma (> 49 years), pancreatic adenocarcinoma (> 56 years), hepatocellular carcinoma (35-90 years), rectal adenocarcinoma (<59 years in White; < 52 years in Non-White) and anal squamous cell carcinoma (<51 years in White; < 58 years in Non-White). Patients with well-differentiated tumors had better long-term prognoses compared to those with poorly-differentiated tumors (all P < 0.05). Conclusion: The patterns of relationship between age and tumor grade were different in patients with different types of digestive tumor, which may be a reflection of the distinct molecular subtypes of these tumors.


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