{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:39:39Z","timestamp":1782931179376,"version":"3.54.5"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":35,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reconstruction of female oncologic peripelvic defects is challenging due to complex anatomy, neoadjuvant chemoradiation, operative resection margins, and wound healing risks. Functional restoration requires thoughtful management focused on defect reconstruction and patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review of peripelvic reconstruction in female patients at MD Anderson Cancer Center from 2016 to 2023. Data collected included the patient's\u00a0comorbidities, tumor characteristics, and reconstructive details. Complications were classified as nonoperative or operative within 30 days. Patient outcomes included hernia rates, sexual activity, and revision needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the study period, 164 patients underwent peripelvic defect reconstruction. Most had colorectal (57%), anal (17%), or gynecologic malignancies (10%). 83% had prior radiation. 33.3% had Class II or III obesity. The most common resection was open colorectal resection with partial vaginectomy (66%). Pedicled flaps (93%) were frequently used, mainly vertical rectus abdominis muscle (65%) and gracilis (11%). For multi\u2010visceral resections, abdominal\u2010based flaps were used in 95% of open cases\u00a0and thigh\u2010based flaps in 88.9% of robotic cases. 51% had formal abdominal wall repair. Complications occurred in 47%, with 9.1% needing surgery. Postoperative hernias were reported in 4.9%, with 3% requiring repair. Approximately 11% reported being sexually active at the last follow\u2010up. Of those instructed on vaginal dilator therapy (42%), 24.6% were sexually active.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Peri\u2010pelvic soft tissue reconstruction in the oncologic population is safe. Operative complications and hernia rates are low. In robotic surgery, thigh\u2010based flaps are increasingly used to reconstruct the peripelvic region. Return to sexual activity is higher in patients when given dilator therapy instruction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.27800","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:45:51Z","timestamp":1730853951000},"page":"1119-1129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Contemporary role of the plastic and reconstructive surgeon in the outcome of female peripelvic defects after oncologic extirpation"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3757-9429","authenticated-orcid":false,"given":"Ashley","family":"Shin","sequence":"first","affiliation":[{"name":"McGovern Medical School at UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Elmorsi","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive 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