Laparoscopic extralevator abdominoperineal resection with perineal reconstruction with gluteal flap (clinical case)

AIM: to demonstrate the first experience of extralevator abdominoperineal resection (ELAPR) with gluteoplasty.PATIENTS AND METHODS: patient K., aged 71 years old, with a low rectal cancer cT3aN0M1a CRM– EMVI+ (IV st) after neoadjuvant chemoradiation therapy, underwent surgery. Laparoscopic extralevator abdominoperineal resection with gluteoplasty was performed.RESULTS: the patient was mobilized on the next day after surgery, the drain tubes were removed on the 5th day. On the 7th day, the seroma of the perineal wound without signs of suppuration was drained. No discomfort or movement disorders were noted. The patient was discharged in satisfactory condition on the 17th day.CONCLUSION: the presented clinical case allows us to consider gluteoplasty as a promising method for reconstruction of the pelvic floor defect after ELAPR.

Laparoscopic extralevator abdominoperineal resection with perineal reconstruction with gluteal flap (clinical case)

AIM: to demonstrate the first experience of extralevator abdominoperineal resection (ELAPR) with gluteoplasty.PATIENTS AND METHODS: patient K., aged 71 years old, with a low rectal cancer cT3aN0M1a CRM– EMVI+ (IV st) after neoadjuvant chemoradiation therapy, underwent surgery. Laparoscopic extralevator abdominoperineal resection with gluteoplasty was performed.RESULTS: the patient was mobilized on the next day after surgery, the drain tubes were removed on the 5th day. On the 7th day, the seroma of the perineal wound without signs of suppuration was drained. No discomfort or movement disorders were noted. The patient was discharged in satisfactory condition on the 17th day.CONCLUSION: the presented clinical case allows us to consider gluteoplasty as a promising method for reconstruction of the pelvic floor defect after ELAPR.

Gluteal Flap for Pressure Sores

Pressure sores usually occur over bony prominences. Based on the distribution of pressure, sacral pressure sores are more common in supine patients, and ischial pressure sores are more common in sitting patients. Patients in acute care settings, in nursing homes, or with spinal cord injuries are among the most commonly affected populations. Pressure sores are a recurrent problem with multiple risk factors including direct pressure, friction, shearing forces, immobility, and moisture. Malnutrition, anemia, and chronic illness can also contribute to their formation by the impairment of blood supply and delayed wound healing. This chapter reviews the operative technique for using different types of gluteal flaps as coverage for sacral pressure sores. It highlights essential components of preoperative, operative, and postoperative decision-making and common postoperative complications encountered.

THE SUPERIOR GLUTEAL FLAP – BREAST RECONSTRUCTION – ANATOMIC DISSECTION ON A CADAVER

The reconstruction of the breast after an oncological mastectomy is a challenge for the plastic surgeons. During the dissection of one fresh, female cadaver, age 63, a free superior gluteal flap was taken from the gluteal region, using loupe magnification. The dissection preparations were photographed with a high definition camera. The harvesting of the superior gluteal musculocutaneous fat-pad flap and the closure of the donor area in layers advantages and disadvantages of using the superior gluteal flap in the reconstruction of the amputated breast.