[Vaginal reconstruction after pelvic exenteration: when and which techniques?]

Pelvic exenterations are commonly performed to treat locally advanced or recurrent tumours of the pelvic organs to achieve long-term survival. Those procedures may present complications. Reconstructive procedures have become an important part of radical pelvic surgery to improve quality of life. Various surgical procedure of vaginal reconstruction have been describe. Myocutaneous flaps are effective in the prevention of major morbidity with pelvic filling and physiological neovagina. Vertical rectus abdominis myocutaneous flap is the technique of choice with simple harvesting and large pelvic filling. Gracilis and gluteal thight flaps are particularly adapted in pelvectomy with perineal resection. Enteroclpoplasty and omental flap must be used in radical colpectomie or difficulty pelvic access.