Experience of the perineum defects reconstruction with the fasciocutaneous lotus petal flap after resection of anogenital skin tumors
https://doi.org/10.17650/1726-9776-2025-21-1-100-106
Abstract
Malignant tumors affecting perineum skin are rare. The most common neoplasms of this area are squamous cell carcinoma, melanoma, and extramammary Paget’s disease. The most effective treatment for patients with nonmetastatic types of these malignant tumors is surgery. Despite relative technical simplicity of radical resection of the affected skin, the difficulties of defects reconstruction often limits the possibilities of surgical treatment. One of the techniques for replacement of medium-sized and large defects after surgical treatment of anogenital skin tumors is the use of regional fasciocutaneous lotus petal flap. The article presents descriptions of clinical cases of this technique using in 4 patients including 3 women with vulvar cancer and a man with extramammary Paget’s disease.
Supporting agencies: The study was performed without external funding
About the Authors
M. I. Volkova
Oncology Center No. 1, Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Mariya Igorevna Volkova
Build. 7, 18A Zagorodnoe Shosse, Moscow 117152; Build. 1, 2/1 Barrikadnaya St., Moscow 125993
Competing Interests:
The authors declare no conflict of interest
E. V. Cherepanova
Moscow Multidisciplinary Clinical Center “Kommunarka”, Moscow Healthcare Department
Russian Federation
Competing Interests:
Russian Federation
8 Sosenskiy Stan St., Kommunarka, Moscow 108814
Competing Interests:
The authors declare no conflict of interest
Ya. V. Gridneva
Oncology Center No. 1, Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
Build. 7, 18A Zagorodnoe Shosse, Moscow 117152; 8 Trubetskaya St., Moscow 119991
Competing Interests:
The authors declare no conflict of interest
I. S. Al-Akel
Oncology Center No. 1, Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department
Russian Federation
Competing Interests:
Russian Federation
Build. 7, 18A Zagorodnoe Shosse, Moscow 117152
Competing Interests:
The authors declare no conflict of interest
References
1. Carr D., Pootrakul L., Harmon J., Trotter S. Cutaneous malignancies of the perineum. Clin Obstet Gynecol 2015;58(1):158–71. DOI: 10.1097/GRF.0000000000000079
2. Del Pino A., Abcarian H. The difficult perineal wound. Surg Clin North Am 1997;77(1):155–74. DOI: 10.1016/s00396109(05)705375
3. Mughal M., Baker R.J., Muneer A., Mosahebi A. Reconstruction of perineal defects. Ann R Coll Surg Engl 2013;95(8):539–44. DOI: 10.1308/rcsann.2013.95.8.539
4. Horton C.E., Adamson J.E., Mladick R.A. et al. Flaps of the genital area. In: Plastic and reconstructive surgery of the genital area. Ed.: C.E. Horton. Boston, MA: Little, Brown, 1973.
5. Yii N.W., Niranjan N.S. Lotus petal flaps in vulvovaginal reconstruction. Br J PlastSurg 1996;49(8):547–54. DOI: 10.1016/s00071226(96)901320
6. Manchot C. The cutaneous arteries of the human body. Translated by Ristic J. and Morain W.D. NewYork: SpringerVerlag, 1983.
7. Warrier S.K., Kimble F.W., Blomfield P. Refinements in the lotus petal flap repair of the vulvoperineum. ANZ J Surg 2004;74(8):684–8. DOI: 10.1111/j.14451433.2004.03119.x
8. Argenta P.A., Lindsay R., Aldridge R.B. et al. Vulvar reconstruction using the “lotus petal” fasciocutaneous flap. Gynecol Oncol 2013;131(3):726–9. DOI: 10.1016/j.ygyno.2013.08.030
9. Bodin F., Weitbruch D., SeigleMurandi F. et al. Vulvar reconstruction by a “suprafascial” lotus petal flap after surgery for malignancies. Gynecol Oncol 2012;125(3):610–3. DOI: 10.1016/j.ygyno.2012.03.029
10. Sawada M., Kimata Y., Kasamatsu T. et al. Versatile lotus petal flap for vulvoperineal reconstruction after gynecological ablative surgery. Gynecol Oncol 2004;95(2):330–5. DOI: 10.1016/j.ygyno.2004.07.038
11. Ragoowansi R., Yii N., Niranjan N. Immediate vulvar and vaginal reconstruction using gluteal fold flap: longterm results. Br J Plast Surg 2004;57(5):406–10. DOI: 10.1016/j.bjps.2004.02.022
12. Salgarello M., Farallo E., BaroneAdesi L. et al. Flap algorithm in vulvar reconstruction after radical, extensive vulvectomy. Ann Plast Surg 2005;54(2):184–90. DOI: 10.1097/01.sap.0000141381.77762.07
13. Buda A., Confalonieri P.L., Rovati L.C. et al. Tunneled modified lotus petal flap for surgical reconstruction of severe introital stenosis after radical vulvectomy. Int J Surg Case Rep 2012;3(7):299–301. DOI: 10.1016/j.ijscr.2012.03.024
14. Roda J.L.H., Abella J.A.L., Maazouzi Y. et al. Vulvar reconstruction in vulvar cancer: “lotus petal” suprafascial flap. Gynecol Surg 2016;13:51–5.
15. Buja Z. Lotus petal flap reconstruction of labia major and perineum after necrotizing fasciitis infection: a case report. SAGE Open Med Case Rep 2024;12:2050313X241242593. DOI: 10.1177/2050313X241242593
16. Hellinga J., Rots M., Werker P.M.N., Stenekes M.W. Lotus petal flap and vertical rectus abdominis myocutaneous flap in vulvoperineal reconstruction: a systematic review of differences in complications. J Plast Surg Hand Surg 2021;55(2):67–82. DOI: 10.1080/2000656X.2020.1828902
17. Hashimoto I., Murakami G., Nakanishi H. et al. First cutaneous branch of the internal pudendal artery: an anatomic basis for the socalled gluteal fold flap. Okajimas Folia Anat Jpn 2001;78(1):23–30. DOI: 10.2535/ofaj1936.78.1_23
18. Ogino M., Sakamoto T., Inoue J. et al. Reconstruction of surgical defects using the gluteus maximus myocutaneous flap following radical vulvectomy. Asia Oceania J Obstet Gynaecol 1992;18(1):23–9. DOI: 10.1111/j.14470756.1992.tb00295.x
19. Gleeson N.C., Baile W., Roberts W.S. et al. Pudendal thigh fasciocutaneous flaps for vaginal reconstruction in gynecologic oncology. Gynecol Oncol 1994;54(3):269–74. DOI: 10.1006/gyno.1994.1209
20. Giannini A., Donato V.D., D’Oria O. et al. The VY gluteal fold advancement flap: outcomes following radical surgery for vulvar malignancies. Int J Gynaecol Obstet 2021;152(3):421–4. DOI: 10.1002/ijgo.13430
21. Wee J.T., Joseph V.T. A new technique of vaginal reconstruction using neurovascular pudendalthigh flaps: a preliminary report. Plast Reconstr Surg 1989;83(4):701–9. DOI: 10.1097/0000653419890400000018
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For citations:
Volkova M.I., Cherepanova E.V., Gridneva Ya.V., Al-Akel I.S. Experience of the perineum defects reconstruction with the fasciocutaneous lotus petal flap after resection of anogenital skin tumors. Cancer Urology. 2025;21(1):100-106. (In Russ.) https://doi.org/10.17650/1726-9776-2025-21-1-100-106
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