Two Cases of Vaginal Reconstruction Using a Transpositional Flap with Combined Resection of Posterior Wall of the Vagina

Abstract

Case 1 involved a 67-year-old woman who underwent abdominoperineal resection after chemoradiotherapy for anal canal cancer. Six months after the operation, local recurrence was observed in the posterior wall of the vagina, and local resection was performed. Case 2 involved a 71-year-old woman. Abdominoperineal resection with combined resection of the posterior wall of the vagina was performed for rectal cancer invading the vagina. We used a transpositional flap for the reconstruction of the defected vaginal posterior wall in both cases.

The reconstruction using a transposition flap can be completed in the same operative field of abdominoperineal resection, where the patient's body position is kept intact. It permits to perform surgery only by a surgeon at a facility without a plastic surgeon, because it is a minimally invasive and easy method compared with other methods. In addition, by mastering this procedure, we can avoid easy detachment from the vaginal wall and resection with insufficient margins.

This procedure can be a useful reconstruction method for resection that requires combined resection of the posterior wall of the vagina.