Reconstruction of the Vulvar Defects After Cancer Ablative Surgery Using Rhomboid Flap and Anterolateral Thigh Flap

doi:10.3877/cma.j.issn.1673-5250.2014.01.019

Objective

To reveal the clinical outcome reconstruction of the vulvar defects with rhomboid flap and anterolateral thigh flap in following cancer ablative surgery.

Methods

From July 2007 to June 2012, 9 patients with vulvar cancer who underwent surgery were retrospectively studied. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Cancer Hospital of Shantou University Medical College. Informed consent was obtained from each patients. Unilateral or bilateral rhomboid flaps and anterolateral thigh flap were used in vulvar defects. The incision healing and evaluation of the vulvar configuration were observed, the urination and sexual life 6 months postoperatively were performed.

Results

Unilateral or bilateral rhomboid flaps were used in 7 patients (77.8%) , anterolateral thigh flaps were used in 2 patients(22.2%) in the study. All patients had a well-shaped vulvar configuration with good elasticity, without scar contracture, urination deflection, or virginal stricture observed, and all flaps survived completely in 9 patients (100%) . 4 patients restored sexual life.

Conclusions

Reconstruction of the vulvar defects according to their dimension with unilateral/ bilateral rhomboid flaps or anterolateral thigh flaps has some clinical value which can rebuild the patients' vulvar anatomic shape and improve their quality of life.

Key words: Vulvar neoplasm, Anterolateral thigh flap, Rhomboid flap, Vessel crisis

表1 9例患者的临床资料

Table 1 Clinical data of 9 patients

序号	年龄(岁)	病理学检查结果	FIGO分期	外阴缺损面积(cm)	是否复发	累及部位	修复方法
1	65	子宫内膜腺癌转移	－	7 × 5	否	阴道口	双侧菱形皮瓣
2	69	鳞癌	Ⅰ	9× 6	否	尿道口	单侧菱形皮瓣
3	83	鳞癌	Ⅰ	7 × 5	否	无	单侧菱形皮瓣
4	36	鳞癌	Ⅰ	8× 5	否	阴道口	双侧菱形皮瓣
5	63	鳞癌	Ⅱ	9× 5	否	无	单侧菱形皮瓣
6	55	恶性黑色素瘤	Ⅱ	16 × 10	是	尿道/阴道	股前外侧皮瓣
7	34	腺癌	Ⅱ	9× 6	是	阴道口	双侧菱形皮瓣
8	67	鳞癌	Ⅲ	14 × 9	是	阴道	股前外侧皮瓣
9	82	鳞癌	Ⅱ	8 × 6	否	无	单侧菱形皮瓣

表1 9例患者的临床资料

Table 1 Clinical data of 9 patients

序号	年龄(岁)	病理学检查结果	FIGO分期	外阴缺损面积(cm)	是否复发	累及部位	修复方法
1	65	子宫内膜腺癌转移	－	7 × 5	否	阴道口	双侧菱形皮瓣
2	69	鳞癌	Ⅰ	9× 6	否	尿道口	单侧菱形皮瓣
3	83	鳞癌	Ⅰ	7 × 5	否	无	单侧菱形皮瓣
4	36	鳞癌	Ⅰ	8× 5	否	阴道口	双侧菱形皮瓣
5	63	鳞癌	Ⅱ	9× 5	否	无	单侧菱形皮瓣
6	55	恶性黑色素瘤	Ⅱ	16 × 10	是	尿道/阴道	股前外侧皮瓣
7	34	腺癌	Ⅱ	9× 6	是	阴道口	双侧菱形皮瓣
8	67	鳞癌	Ⅲ	14 × 9	是	阴道	股前外侧皮瓣
9	82	鳞癌	Ⅱ	8 × 6	否	无	单侧菱形皮瓣

图1 外阴术后缺损

Figure 1 Vulvar defects after cancer ablative surgery

图2 双侧菱形皮瓣修复后

Figure 2 Reconstruction of vulvar defects with rhomboid flap

图3 股前外侧皮瓣修复后

Figure 3 Reconstruction of vulvar defects with anterolateral thigh flap

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