Reconstruction of the Perineum with a Pelvic Floor Defect Using a Short Gracilis Myocutaneous Flap－Review of Complications

Abstract

　For tumorectomy involving a defect of the pelvic floor, body-surface plasty and muscle/soft tissue filling are necessary. Gracilis myocutaneous flaps have the following advantages: they do not interfere with laparoscopic surgery; there is no necessity of intraoperative postural change; and the site of flap placement is out of the preoperative irradiation field. Objective: We investigated the stability and issues of reconstruction of pelvic floor defects after tumorectomy with short gracilis myocutaneous flaps. Subjects and Methods: The subjects were 6 patients who had undergone reconstruction of pelvic floor defects after tumorectomy with short gracilis myocutaneous flaps in our department between May 2017 and October 2018. Results: In all patients, flap survival was achieved. The mean age was 66.3 years. The subjects consisted of 2 males and 4 females. The mean pelvic floor defect size was 5.8 cm. Reconstruction with a unilateral flap was performed in 4 patients, and that with bilateral flaps in 2. Complications were observed in 2. Discussion: The results of reconstruction are stable in patients for whom this procedure should be indicated; this procedure is useful. However, there may be a shortage of reconstructive tissue in those with extensive tissue defects.