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Bowel seromuscular flaps used to repair pelvic defects in patients undergoing reoperative surgery

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Abstract

Background

Pedicled seromuscular bowel flaps may serve as an alternative for pelvic floor reconstruction when conventional omental and muscular flaps are not an option in patients undergoing reoperative abdominopelvic surgery. The aim of this study was to evaluate a unique series of bowel seromuscular flaps used to obliterate intrapelvic defects.

Methods

We conducted a retrospective study on all patients in a single tertiary care institutional database who had undergone pelvic reconstruction with a seromuscular bowel flap from January 2006 to December 2018. The primary outcomes measured were the 30-day morbidity and mortality rates.

Results

Twelve patients (6 men 6 women, median age 56.5 years [range 33–77 years]) underwent reoperative abdominopelvic surgery requiring the use of a native small or large seromuscular bowel flap to obliterate pelvic defects. The indications for surgery included chronic infections, fistulizing Crohn’s disease, and cancer. In all cases, no residual omentum was available and rectus abdominis muscle flaps were not feasible due to prior operative scars. Thirty-day morbidity occurred in 5 patients (42%), and included urine leak from ureteral injury, anastomotic leak, acute kidney injury, and superficial surgical site infection. No flaps became ischemic or required removal in the postoperative setting. No mortality was recorded.

Conclusions

Bowel seromuscular flaps are a feasible and safe alternative for covering pelvic defects in patients who are undergoing reoperative surgery without the option to use traditional omental and muscular flaps.

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Acknowledgements

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Funding

No specific funding was received from any bodies in the public, commercial or not-for-profit sectors to carry out the work described in this article.

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Authors and Affiliations

  1. Kirk Kerkorian School of Medicine at University of Nevada Las Vegas, Las Vegas, NV, USA

    J. S. Bauzon

  2. Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA

    N. V. Tran

  3. Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 1St Street SW, Rochester, MN, 55905, USA

    B. R. Hebert & K. L. Mathis

Authors
  1. J. S. Bauzon
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  2. N. V. Tran
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  3. B. R. Hebert
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  4. K. L. Mathis
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JSB and BRH. The first draft of the manuscript was written by JSB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to K. L. Mathis.

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Bauzon, J.S., Tran, N.V., Hebert, B.R. et al. Bowel seromuscular flaps used to repair pelvic defects in patients undergoing reoperative surgery. Tech Coloproctol 27, 373–378 (2023). https://doi.org/10.1007/s10151-022-02697-8

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  • DOI: https://doi.org/10.1007/s10151-022-02697-8

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