{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T08:11:11Z","timestamp":1775808671793,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017957","name":"Health Commission of Guizhou Province","doi-asserted-by":"publisher","award":["GZWKJ2025-097"],"award-info":[{"award-number":["GZWKJ2025-097"]}],"id":[{"id":"10.13039\/100017957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Cervical squamous cell carcinoma (CSCC) is one of the most common gynecological malignancies, and radiotherapy is a key treatment modality. This paper reports a case of a 51-year-old female patient with cervical squamous cell carcinoma who developed a recurrence in the vaginal wall following radiotherapy. The patient was diagnosed with stage IIIb cervical squamous cell carcinoma four years ago and underwent radical radiotherapy at another hospital. Treatment consisted of pelvic external beam radiotherapy (50 Gy in 25 fractions) combined with two-dimensional brachytherapy (6 Gy in 4 fractions), yielding a total EQD2 of 82 Gy. The treatment proceeded without complications, and no significant radiation-induced damage was observed; however, the patient did not attend regular follow-up appointments after radiotherapy. During this follow-up, squamous cell carcinoma (keratinising type) of the vaginal wall was identified. Following a comprehensive evaluation that ruled out surgical contraindications, the patient underwent laparoscopic total hysterectomy, bilateral salpingo-oophorectomy, and total vaginectomy combined with vaginal packing using a pedicled omental flap. Given the presence of radiotherapy-induced vaginal fibrosis, total vaginectomy carries a heightened risk of poor wound healing, as well as an increased risk of bladder and bowel injuries, which would be challenging to manage in a subsequent repair. To promote healing of the vaginal stump and prevent the occurrence of vesicovaginal and rectovaginal fistulas, the vaginal stump was packed with an omental flap during the procedure. The pedicled omentum flap has a rich blood supply and lymphatic drainage; when packed into the vaginal stump during surgery, it effectively promotes local tissue healing, forms a biological barrier to isolate the bladder from the rectum, and significantly reduces the incidence of fistula formation. A full abdominal and pelvic CT scan performed three months post-operatively revealed no significant abnormalities in the vaginal wall, providing preliminary confirmation of the procedure's safety and efficacy. Given that the clinical management of such patients remains challenging, this case offers a new technical reference for the diagnosis and treatment of similar cases, emphasising the importance of individualised, multidisciplinary, comprehensive treatment, and holds potential clinical value for improving the prognosis of these patients.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1779661","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T07:36:18Z","timestamp":1775806578000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of omental flap in total vaginectomy for post-radiotherapy recurrent cervical cancer: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Haixia","family":"Shu","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lixia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoling","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Imaging, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunmei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianli","family":"He","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi)","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"782030","DOI":"10.3389\/fonc.2022.782030","article-title":"Prognostic effect of primary recurrence patterns in squamous cervical carcinoma after radical surgery","volume":"12","author":"Zhang","year":"2022","journal-title":"Front Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1148\/radiol.2017170963","article-title":"Identification of distant metastatic disease in uterine cervical and endometrial cancers with FDG PET\/CT: analysis from the ACRIN 6671\/GOG 0233 multicenter trial","volume":"287","author":"Gee","year":"2018","journal-title":"Radiology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ygyno.2017.03.022","article-title":"An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology (SGO) recommendations","volume":"146","author":"Salani","year":"2017","journal-title":"Gynecol Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1097\/IGC.0000000000000416","article-title":"Surgical treatment of microinvasive cervical cancer: analysis of pathologic features with implications on radicality","volume":"25","author":"Yoneda","year":"2015","journal-title":"Int J Gynecol Cancer"},{"key":"B5","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical cancer","volume":"393","author":"Cohen","year":"2019","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1111\/IGC.0b013e3181a130f3","article-title":"Surveillance procedures for patients for cervical carcinoma: a review of the literature","volume":"19","author":"Zanagnolo","year":"2009","journal-title":"Int J Gynecol Cancer"},{"key":"B7","doi-asserted-by":"publisher","first-page":"302","DOI":"10.3389\/fonc.2021.618485","article-title":"Analysis of risk factors for recurrence after radiotherapy for locally advanced uterine cervical cancer and construction of a predictive model for column line drawing","volume":"3","author":"Hong","year":"2023","journal-title":"J Pract Obstet Gynecol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1016\/j.annonc.2023.10.694","article-title":"VPS-2023: primary results from BEATce (ENGOT-Cx10\/GEICO 68-C\/JGOG1084\/GOG-3030), a randomised phase III trial of first-line atezolizumab (atezo) combined with a platinum doublet and bevacizumab (bev) for meta-static(stage IVB), persistent or recurrent cervical cancer(R\/M CC)","volume":"34","author":"Oaknin","year":"2023","journal-title":"Ann Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3209","DOI":"10.1111\/jog.15432","article-title":"Patterns and predictors of site-specific recurrence in cervical cancer after radical hysterectomy","volume":"48","author":"Kato","year":"2022","journal-title":"J Obstet Gynaecol Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1186\/s12889-024-19240-z","article-title":"Prevalence and risk factors of human papilloma virus infection among women living with HIV, Egypt, a cross sectional study","volume":"24","author":"Ashry","year":"2024","journal-title":"BMC Public Health"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e42254","DOI":"10.1371\/journal.pone.0042254","article-title":"Is there an increased risk of post-operative surgical site infection after orthopaedic surgery in HIV patients? A systematic review and meta-analysis","volume":"7","author":"Kigera","year":"2012","journal-title":"PLoS One"},{"key":"B12","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1097\/PRS.0b013e31821e6fd2","article-title":"Use of adjuvant techniques improves surgical outcomes of complex vertical rectus abdominis myocutaneous flap reconstructions of pelvic cancer defects","volume":"128","author":"Campbell","year":"2011","journal-title":"Plast Reconstr Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1097\/SHK.0000000000001428","article-title":"The greater omentum-A vibrant and enigmatic immunologic organ involved in injury and infection resolution","volume":"53","author":"Wang","year":"2020","journal-title":"Shock"},{"key":"B14","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.reth.2019.07.008","article-title":"Omentum a powerful biological source in regenerative surgery","volume":"11","author":"Di Nicola","year":"2019","journal-title":"Regen Ther"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e14567","DOI":"10.1097\/MD.0000000000014567","article-title":"Single- versus 2-stage reconstruction for chronic post-radiation chest wall ulcer: a 10-year retrospective study of chronic radiation-induced ulcers","volume":"98","author":"Zhou","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"220","DOI":"10.3760\/cma.j.cn113855-20210805-00473","article-title":"Efficacy analysis of ureteral reimplantation combined with tunica vaginalis tamponade in the treatment of vesicorectal fistula after Hartmann's operation","volume":"37","author":"Chen","year":"2022","journal-title":"Chinese J Gene Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1177\/2292550317731762","article-title":"Laparoscopic harvesting of omental flaps for breast reconstruction-a review of the literature and outcome analysis","volume":"26","author":"Shash","year":"2018","journal-title":"Plast Surg (Oakv)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1055\/s-0038-1677524","article-title":"Comparison of outcomes in oncoplastic pelvic reconstruction with VRAM versus omental flaps: a large cohort analysis","volume":"35","author":"Chaudhry","year":"2019","journal-title":"J Reconstr Microsurg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1676","DOI":"10.1016\/j.suronc.2011.12.008","article-title":"Management of recurrent cervical cancer: a review of the literature","volume":"12","author":"Monk","year":"2014","journal-title":"JNCCN"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.6004\/jnccn.2023.0062","article-title":"NCCN Guidelines\u00ae Insights: cervical cancer, version 1.2024","volume":"21","author":"Abu-Rustum","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.19538\/j.fk2018090108","article-title":"Interpretation of the \u201c2018 NCCN clinical practice guidelines for cervical cancer (First edition)\u201d","volume":"33","author":"Hui","year":"2017","journal-title":"Chin J Pract Gynecol Obstet"},{"key":"B22","doi-asserted-by":"publisher","first-page":"112229","DOI":"10.1016\/j.ejmech.2020.112229","article-title":"Targeting drug delivery system for platinum (\u2163)-Based antitumor complexes","volume":"194","author":"Zhong","year":"2020","journal-title":"Eur J Med Chem"},{"key":"B23","doi-asserted-by":"publisher","first-page":"64","DOI":"10.6004\/jnccn.2019.0001","article-title":"Cervical cancer, version 3.2019, NCCN clinical practice guidelines in oncology","volume":"17","author":"Koh","year":"2019","journal-title":"J Natl Compr Canc Netw"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e30","DOI":"10.3802\/jgo.2024.35.e30","article-title":"Recent breakthroughs in the management of locally advanced and recurrent\/metastatic cervical cancer","volume":"35","author":"Garc\u00eda","year":"2024","journal-title":"J Gynecol Oncol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/S0140-6736(24)00317-9","article-title":"Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11\/GOG-3047\/KEYNOTE-A18): a randomised, double-blind, phase 3 clinical trial","volume":"403","author":"Lorusso","year":"2024","journal-title":"Lancet"},{"key":"B26","doi-asserted-by":"publisher","first-page":"625","DOI":"10.19538\/j.fk2023020115","article-title":"Interpretation of the NCCN clinical practice guidelines for cervical cancer (2023 edition)","volume":"39","author":"Zhou","year":"2023","journal-title":"Chin J Pract Gynecol Obstet"},{"key":"B27","doi-asserted-by":"publisher","first-page":"625","DOI":"10.19538\/j.fk2023110115","article-title":"Interpretation of the 2024 NCCN clinical practice guidelines in oncology for cervical cancer","volume":"40","author":"Hui","year":"2024","journal-title":"Chin J Pract Gynecol Obstet"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1779661\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T07:36:21Z","timestamp":1775806581000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1779661\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":27,"alternative-id":["10.3389\/fsurg.2026.1779661"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1779661","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"article-number":"1779661"}}