{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T23:59:09Z","timestamp":1774396749483,"version":"3.50.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Pelvic exenteration for locally advanced or recurrent malignancies results in a large pelvic dead space and complex perineal defects, presenting formidable reconstructive challenges. Conventional methods, such as the vertical rectus abdominis myocutaneous (VRAM) flap, are effective but associated with significant donor-site morbidity and flap-specific complications. To overcome these limitations, the colonic flap was developed, a technique that utilizes a vascularized segment of sigmoid colon harvested within the operative field. This approach has two main applications: a mucosa-intact sigmoid flap for neovaginal reconstruction, and a mucosa-removed colonic flap for pelvic floor reconstruction and dead-space obliteration. This review outlines the limitations of existing techniques, the rationale for the colonic flap, its surgical principles, indications, clinical outcomes, and limitations. Based on more than a decade of clinical experience, the colonic flap has proven to be a safe, versatile, and effective reconstructive option. It avoids donor-site morbidity, is fully compatible with minimally invasive surgery, and provides excellent functional and oncologic outcomes. The colonic flap should be considered a valuable addition to reconstructive options in advanced pelvic surgery.<\/jats:p>","DOI":"10.3389\/fonc.2025.1695995","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:12:58Z","timestamp":1763442778000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The colonic flap: a versatile and reliable donor-site-free technique for pelvic reconstruction after 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