Vaginal reconstruction with gracilis myocutaneous flap after extended abdominoperineal resection.

概要

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We recently carried out vaginal reconstruction by use of a unilateral gracilis myocutaneous flap. The patient was a 39-year-old woman in whom rectal cancer had invaded to the posterior wall of the vagina. After abdominoperineal resection including vaginectomy, reconstruction of the vagina was performed immediately. The gracilis myocutaneous flap for vaginal reconstruction was first reported by McCraw and associates in 1976. This technique is able to move enough tissue volume for the repair of a large defect after radical procedures such as pelvic exenteration and extensive abdominoperineal resection. It also alows simultareous reconstruction of a functional vagina. We often encounter shortening and narrowing of the vagina after abdominoperineal resection including vaginectomy, making it impossible for these patients to have sexual intercourse. The reconstruction of a functional vagina immediately is of significant importance especially in younger women. The gracilis myocutaneous procedure thus seems to he a worthwhile and appropriate technique.
日本大腸肛門病学会の論文