{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:15:33Z","timestamp":1787976933284,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"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":["Colorectal Disease"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Total pelvic exenteration (TPE) can be complicated by empty pelvis syndrome (EPS), and none of the currently available procedures completely mitigate this problem. The aim of this study was to evaluate the feasibility and effectiveness of a pedicled anterolateral thigh (p\u2010ALT) flap for preventing EPS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>All cases of TPE at the National Cancer Center Hospital in Tokyo between 2008 and 2022 were retrospectively reviewed. The main indication for TPE was colorectal cancer, with some other malignancies. Background factors, surgical outcomes and postoperative complications were compared between patients who underwent primary suture closure (the PC group) and those who underwent p\u2010ALT flap reconstruction (the flap group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 114 patients underwent TPE during the study period. Twenty patients in whom a different procedure was performed or a different flap was used for reconstruction were excluded, leaving 94 for analysis (PC group, <jats:italic>n<\/jats:italic>\u2009=\u200954; flap group, <jats:italic>n<\/jats:italic>\u2009=\u200940). There was no significant between\u2010group difference in patient characteristics. Severe pelvic abscess developed in 12 patients (22.2%) in the PC group and 2 (5%) in the flap group. Multivariable analysis identified a significantly lower risk of severe pelvic abscess in the p\u2010ALT flap reconstruction (OR 0.07, 95% CI 0.01\u20130.58, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). EPS\u2010related readmissions were more common in the PC group [37.0% (20\/54) vs. 25% (10\/40)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of severe pelvic abscesses and readmission for EPS was significantly lower after perineal reconstruction with a p\u2010ALT flap. Perineal reconstruction with this flap is a feasible and effective method in TPE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.17239","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T06:14:07Z","timestamp":1731651247000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A pedicled anterolateral thigh flap decreased the risk of empty pelvis syndrome following total pelvic exenteration"],"prefix":"10.1111","volume":"27","author":[{"given":"Shintaro","family":"Hirata","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery National Cancer Center Hospital  Tokyo Japan"},{"name":"Course of Advanced Clinical Research of Cancer Juntendo University Graduate School of Medicine  Tokyo 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