Abstract
Locally advanced rectal cancer, invading the posterior wall of the vagina can be resected with abdominoperineal resection with resection of the posterior portion of the vagina. Total pelvic excision may be avoided by preservation of the anterior portion of the vagina which prevents damage of the bladder and urethra. So far invasive various flaps, such as rectus abdominus myocutaneous flap, gracilis myocutaneous flap, and tensor fascia lata musculocutaneous flap have been used for the reconstruction of the defected vaginal posterior wall. We encountered 3 cases using ‘transposition flap’ designed from the thigh to the defected posterior vaginal wall, which was easy to perform. The operation time for each case was 437 min, 423 min, 659 min, respectively, and about 120 min was needed for vaginal reconstruction. Postoperative complication was infection and partial dehiscence of the flap in 1 case, and neurogenic bladder in 1 case which had no relation to the reconstruction procedure. Long-term follow-up showed no local recurrence in all cases, except a liver metastasis in 1 case. The transposition flap is a less-invasive and easier method, because it can be completed in the same operative field in the perineum and concurrently performed the abdominal procedure.
