We have treated a 61-year-old man with isolated abdominal wall metastasis of gastric cancer. The abdominal wall defect after tumor and colon resection was reconstructed using a free anterolateral thigh flap. As recipient vessels, we chose intraperitoneal vessels for convenience. Postoperative course was uneventful, and color Doppler sonography was used to postoperatively monitor blood flow in the flap. As a result, the patient could assume a sitting position by 4 days postoperatively. Other reports have described ambulation times of 1 or 2 weeks, due to anxiety about the risk of kinking or elongation of anastomosed vessels with body movement. Using frequent checks with color Doppler sonography, the patient achieved early ambulation after 30 days with no trouble. This method of monitoring shows numerous advantages for abdominal wall reconstruction using intraperitoneal vessels.
