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Vaginal Reconstruction Following Radical Surgery for Colorectal Malignancies: A Systematic Review of the Literature

  • Reconstructive Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Vaginectomy is frequently indicated to ensure an adequate resection in rectal cancer. This paper reviews the success, complications, and functional results after various methods of vaginal reconstruction following resection for rectal tumors.

Methods

A systematic review of the literature was performed by using the MEDLINE database, Embase, and the Cochrane library (1990–2010).

Results

Eighteen papers were available to review. Fifty percent of all women who received a neovagina following vaginectomy returned to sexual activity postoperatively. The rectus abdominis myocutaneous (RAM) flap remains the most common method of vaginal reconstruction after surgery for colorectal cancer. Advantages include low operative morbidity, a wide arc of rotation, and ease of harvest. Alternatives to flap reconstruction of the vagina have limited indications because of higher morbidity rates.

Conclusions

Preferred techniques for vaginal reconstruction following vaginectomy with colorectal cancer resection include RAM flaps for partial posterior vaginal defects and bilateral Gracilis myocutaneous flaps for complete vaginal excisions.

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Authors and Affiliations

  1. Institute for Clinical Outcomes, Research and Education (iCORE) and Department of Surgery, St. Vincent’s University Hospital, Dublin, Ireland

    Adrian McArdle MB, BCh, MRCSI & Desmond C. Winter MD, FRCSI

  2. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Danielle A. Bischof MD, FRCSC & Carol J. Swallow MD, PhD, FRCSC, FACS

  3. Division of Plastic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Kristen Davidge MD

  4. Department of Surgical Oncology, Princess Margaret Cancer Centre and Mount Sinai Hospital, Toronto, ON, Canada

    Carol J. Swallow MD, PhD, FRCSC, FACS

Authors
  1. Adrian McArdle MB, BCh, MRCSI
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  2. Danielle A. Bischof MD, FRCSC
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  3. Kristen Davidge MD
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  4. Carol J. Swallow MD, PhD, FRCSC, FACS
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  5. Desmond C. Winter MD, FRCSI
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Corresponding author

Correspondence to Desmond C. Winter MD, FRCSI.

Additional information

Adrian McArdle and Danielle A. Bischof are joint first authors.

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McArdle, A., Bischof, D.A., Davidge, K. et al. Vaginal Reconstruction Following Radical Surgery for Colorectal Malignancies: A Systematic Review of the Literature. Ann Surg Oncol 19, 3933–3942 (2012). https://doi.org/10.1245/s10434-012-2503-3

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  • DOI: https://doi.org/10.1245/s10434-012-2503-3

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