[Soft tissue reconstruction after total pelvic exenteration]

Total pelvic exenteration leaves a major defect in pelvic-perineal region. Delayed healing, bowel fistulae, occlusion or protrusion and infection are frequent complications of this procedure. During 2000-2006, in General Surgery and Liver Transplantation Fundeni, 73 patients with advanced pelvic cancer and invasive recurrences were operated. For 42 patients, various procedures for pelvic and vaginal reconstruction (omental flap, muscular and musculo-cutaneous flaps--rectus abdominis and gracilis) were performed in order to fill the pelvi-perineal defects and restore form and function. Technical principles, indications, contraindications, advantages and disadvantages of these procedures are outlined. We found that complications related to total pelvic exenteration dramatically decreased and primary healing of the perineal wound was superior, facts that correlate with the literature data.