{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:03:41Z","timestamp":1753887821767,"version":"3.41.2"},"reference-count":11,"publisher":"FapUNIFESP (SciELO)","issue":"2","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"abstract":"<jats:p>ABSTRACT  Background: Abdominoperineal excision of the rectum (APR) remains the only potential curative treatment for very low rectal adenocarcinoma and squamous cell carcinoma of the anus. Yet, it implies a significant perineal exenteration and has set the attention on the perineal reconstruction.  Aim: To present technique used in one case of APR for anal cancer, with resection of the vaginal posterior wall with large perineal defect which has called for the necessity of a flap for reconstruction  Method: To cover the large perineal defect and reconstruct the posterior vaginal wall was perform a standardized and reproducible surgical technique using oblique rectus abdominis myocutaneous (ORAM) flap. The overlying skin of this flap is thick and well vascularized by both superficial branches and perforators of the superior epigastric artery and the deep inferior epigastric artery which serves as the vascular pedicle for the ORAM flap.  Results:  This procedure was applied in a 65-year-old woman with recurrent squamous cell carcinoma of the anus infiltrating the posterior wall of the vagina. Was performed an APR with en-bloc resection of the vaginal posterior wall in order to achieve tumor-free margins. Postoperative course was uneventful and she was discharged home at postoperative day 9. Final pathological report confirmed the oncological adequacy of the procedure (R0) and showed a rypT4N0 lesion.  Conclusion: Flap reconstruction is an effective way to cover the perineal wound reducing both perineal complication rate and wound healing delay. The ORAM is particularly interesting for female whose tumors require resection and subsequent reconstruction of the posterior wall of the vagina.<\/jats:p>","DOI":"10.1590\/0102-672020190001e1507","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T23:05:59Z","timestamp":1605913559000},"source":"Crossref","is-referenced-by-count":2,"title":["PERINEAL REPAIR AFTER ABDOMINOPERINEAL EXCISION WITH RECTUS ABDOMINIS MYOCUTANEOUS FLAP"],"prefix":"10.1590","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4938-5995","authenticated-orcid":false,"given":"Elsa","family":"D\u2019ANNUNZIO","sequence":"first","affiliation":[{"name":"Diaconesses Croix Saint Simon Hospital,  France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5697-3907","authenticated-orcid":false,"given":"Alain","family":"VALVERDE","sequence":"additional","affiliation":[{"name":"Diaconesses Croix Saint Simon Hospital,  France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2527-7949","authenticated-orcid":false,"given":"Renato Micelli","family":"LUPINACCI","sequence":"additional","affiliation":[{"name":"Diaconesses Croix Saint Simon Hospital,  France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"1","key":"ref1","first-page":"252","article-title":"Modified vertical rectus abdominismyocutaneous flap vaginal reconstruction an analysis of surgical outcomes","volume":"125","author":"Berger JL","year":"2012","journal-title":"GynecolOncol"},{"issue":"3","key":"ref2","first-page":"729","article-title":"Snapshot Study on the Value of Omentoplasty in Abdominoperineal Resection with Primary Perineal Closure for Rectal Cancer","volume":"25","author":"Blok RD","year":"2018","journal-title":"Ann SurgOncol"},{"issue":"3","key":"ref3","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1007\/s10350-004-0827-1","article-title":"Primary perineal wound closure after preoperative radiotherapy and abdominoperineal resection has a high incidence of wound failure","volume":"48","author":"Bullard KM","year":"2005","journal-title":"Dis Colon Rectum"},{"issue":"8","key":"ref4","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1007\/s11605-018-3750-9","article-title":"Abdominoperineal Resection for Rectal Cancer in the Twenty-First Century Indications, Techniques, and Outcomes","volume":"22","author":"Hawkins AT","year":"2018","journal-title":"J Gastrointest Surg"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/SAP.0000000000001137","article-title":"Vertical Rectus AbdominisMyocutaneousVersus Alternative Flaps for Perineal Repair After Abdominoperineal Excision of the Rectum in the Era of Laparoscopic Surgery","volume":"79","author":"Johnstone MS","year":"2017","journal-title":"Ann Plast Surg"},{"issue":"5","key":"ref6","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1097\/SLA.0b013e3181bce334","article-title":"Abdomino-perineal resection for anal cancer impact of a vertical rectus abdominismyocutaneus flap on survival, recurrence, morbidity, and wound healing","volume":"250","author":"Lefevre JH","year":"2009","journal-title":"Ann Surg"},{"issue":"5","key":"ref7","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1308\/003588411X572268","article-title":"Rectus abdominismyocutaneous flaps for perineal reconstruction modifications to the technique based on a large single-centre experience","volume":"93","author":"McMenamin D","year":"2011","journal-title":"Ann R CollSurg Engl"},{"issue":"8","key":"ref8","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/j.1463-1318.2008.01743.x","article-title":"Myocutaneous flap reconstruction of the pelvis after abdominoperineal excision","volume":"11","author":"Nisar PJ","year":"2009","journal-title":"Colorectal Dis"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1055\/s-0036-1580627","article-title":"Management of the Perineal Defect after Abdominoperineal Excision","volume":"29","author":"Peirce C","year":"2016","journal-title":"Clin Colon Rectal Surg"},{"issue":"3","key":"ref10","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1055\/s-2007-984865","article-title":"Abdominoperineal resection how is it done and what are the results?","volume":"20","author":"Perry WB","year":"2007","journal-title":"Clin Colon Rectal Surg"},{"issue":"1","key":"ref11","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1055\/s-2008-1055325","article-title":"Perineal wound complications after abdominoperineal resection","volume":"21","author":"Wiatrek RL","year":"2008","journal-title":"Clin Colon Rectal Surg"}],"container-title":["ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S\u00e3o Paulo)"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/abcd\/v33n2\/0102-6720-abcd-33-02-e1507.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T01:14:47Z","timestamp":1611450887000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-67202020000200400&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020]]}},"alternative-id":["S0102-67202020000200400"],"URL":"https:\/\/doi.org\/10.1590\/0102-672020190001e1507","relation":{},"ISSN":["2317-6326","0102-6720"],"issn-type":[{"type":"electronic","value":"2317-6326"},{"type":"print","value":"0102-6720"}],"subject":[],"published":{"date-parts":[[2020]]},"article-number":"e1507"}}