{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:22:24Z","timestamp":1790770944587,"version":"4.1.0"},"reference-count":68,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Abdominoperineal amputation (AAP) is a gold standard procedure treating advanced abdominal and pelvic cancers. The defect resulting from this extensive surgery must be reconstructed to avoid complications, such as infection, dehiscence, delayed healing, or even death. Several approaches can be chosen depending on the patient. Muscle-based reconstructions are a reliable solution but are responsible for additional morbidity for these fragile patients. We present and discuss our experience in AAP reconstruction using gluteal-artery-based propeller perforator flaps (G-PPF) in a case series. Between January 2017 and March 2021, 20 patients received G-PPF reconstruction in two centers. Either superior gluteal artery (SGAP)- or inferior artery (IGAP)-based perforator flaps were performed depending on the best configuration. Preoperative, intraoperative, and postoperative data were collected. A total of 23 G-PPF were performed\u201412 SGAP and 11 IGAP flaps. Final defect coverage was achieved in 100% of cases. Eleven patients experienced at least one complication (55%), amongst whom six patients (30%) had delayed healing, and three patients (15%) had at least one flap complication. One patient underwent a new surgery at 4 months for a perineal abscess under the flap, and three patients died from disease recurrence. Gluteal-artery-based propeller perforator flaps are an effective and modern surgical procedure for AAP reconstruction. Their mechanic properties, in addition to their low morbidity, make them an optimal technique for this purpose; however, technical skills are needed, and closer surveillance with patient compliance is critical to ensure success. G-PPF should be widely used in specialized centers and considered a modern alternative to muscle-based reconstructions.<\/jats:p>","DOI":"10.3390\/jcm12124014","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T02:00:45Z","timestamp":1686621645000},"page":"4014","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Gluteal Propeller Perforator Flaps: A Paradigm Shift in Abdominoperineal Amputation Reconstruction"],"prefix":"10.3390","volume":"12","author":[{"given":"Theodoros","family":"Chrelias","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4190-5132","authenticated-orcid":false,"given":"Yanis","family":"Berkane","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France"},{"name":"Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Shriners Children\u2019s Boston, Harvard Medical School, Boston, MA 02115, USA"},{"name":"Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA"},{"name":"MICMAC, UMR INSERM U1236, Rennes University Hospital, 35033 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0166-4148","authenticated-orcid":false,"given":"Etienne","family":"Rousson","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korkut","family":"Uygun","sequence":"additional","affiliation":[{"name":"Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Shriners Children\u2019s Boston, Harvard Medical School, Boston, MA 02115, USA"},{"name":"Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Meunier","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Digestive Surgery, University of Rennes 1, CHU Rennes, 35700 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kartheuser","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, Department of Surgery, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Watier","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2848-3879","authenticated-orcid":false,"given":"J\u00e9r\u00f4me","family":"Duisit","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France"},{"name":"Department of Plastic and Reconstructive Surgery, H\u00f4pitaux IRIS Sud, 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4602-0432","authenticated-orcid":false,"given":"Nicolas","family":"Bertheuil","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, CHU Rennes, University of Rennes 1, 35700 Rennes, France"},{"name":"Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Shriners Children\u2019s Boston, Harvard Medical School, Boston, MA 02115, USA"},{"name":"MICMAC, UMR INSERM U1236, Rennes University Hospital, 35033 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s12253-014-9863-x","article-title":"Meta-analysis of oncological outcome after abdominoperineal resection or low an-terior resection for lower rectal cancer","volume":"21","author":"Wang","year":"2015","journal-title":"Pathol. 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