SO08 MANAGEMENT OF COMPLEX LARGE VOLUME GROIN TUMOURS WITH RECTUS ABDOMINUS MYOCUTANEOUS FLAPS – A CASE SERIES

Abstract

Purpose Resection of large volume soft tissue tumours and metastatic disease in the groin commonly involves extensive resection of abdominal wall and overlying skin to achieve adequately wide surgical margins. There are many reconstructive techniques available often requiring specialised plastic surgical input. We have routinely used vertical rectus abdominus myocutaneous flaps (VRAM) to reconstruct these defects and our impression was that these simple flaps provided good cover with few complications.Methodology A search of our operative database between 1999 and 2005 to identify large volume groin tumours which had been immediately reconstructed with a VRAM. We recorded information on patient demographics, tumour characteristics, reconstruction type, postoperative complications, follow‐up and survival data.Results 18 patients fulfilled our criteria and were included in the study. Tumour pathology was sarcoma 11 (61%), melanoma 4 (22%) and squamous cell carcinoma 3 (17%). Only 6 cases were potientially curative resections for primary tumours with, 5 palliative procedures for recurrent sarcoma and 7 for metastatic. Patients with palliative resections did poorly with and average survival of 17 months (range 6–36 months) but complications were uncommon with partial flap necrosis requiring split skin grafting in one case only. Curative resections had no local recurrences and one death from disease at 44 months.Conclusion VRAM reconstruction following resection of large volume groin tumours was very successful in our series providing excellent cover in the groin with few complications. The technique is useful in achieving robust surgical palliation and appears equally effective for potentially curative cases.