{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:05:48Z","timestamp":1782515148136,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,6,28]],"date-time":"2020-06-28T00:00:00Z","timestamp":1593302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Following abdominoperineal resection (APR), primary closure of the perineal defect is often possible. Some patients, however, require flap reconstruction. Identifying these patients preoperatively is critical to facilitate comprehensive patient counseling and optimize surgical efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients undergoing APR over a 10\u2010year period was performed to identify predictive factors for patients requiring reconstruction with a vertical rectus abdominis myocutaneous (VRAM) flap as opposed to primary closure. Student's <jats:italic>t<\/jats:italic> and Fisher's exact tests were utilized for statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 158 patients underwent APR, 29 of whom (18%) required a VRAM flap. A higher average skin resection area was seen among those requiring flap reconstruction (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). Flap reconstruction was also associated with current smoking status (<jats:italic>P<\/jats:italic>\u2009=\u2009.0197), anal tumor location (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001), and neoadjuvant radiation (<jats:italic>P<\/jats:italic>\u2009=\u2009.0457). Although not statistically significant, average tumor diameter was larger in the VRAM flap group compared with the primary closure group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While the appropriate method of closure for those undergoing APR should be considered on an individual case basis, patients who smoke, have a tumor located at the anus, or require large skin resection are more likely to need flap reconstruction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26086","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T05:20:43Z","timestamp":1593408043000},"page":"923-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Factors associated with the use of vertical rectus abdominus myocutaneous flap reconstruction following abdominoperineal resection for anorectal cancer"],"prefix":"10.1002","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4657-7844","authenticated-orcid":false,"given":"David S.","family":"Nichols","sequence":"first","affiliation":[{"name":"University of Florida College of Medicine Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9524-9575","authenticated-orcid":false,"given":"Ellen","family":"Satteson","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine Gainesville Florida"},{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery University of Florida Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Harbor","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Georgetown University Hospital  Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"DeFranzo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Wake Forest University School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"David","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Wake Forest University School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"James T.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Section of Plastic and Reconstructive Surgery Virginia Tech Carilion School of Medicine Roanoke 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