Extensive Pelvic Defect Reconstruction Using a Pedicled Vastus Lateralis Myocutaneous Flap: A Case Report

Extensive pelvic resection often results in complications, making flap reconstruction essential for managing pelvic defects. We report a case of successful reconstruction using a pedicled vastus lateralis myocutaneous flap following abdominoperineal resection for anal canal cancer. The flap was transferred through an intermuscular and subcutaneous tunnel into the pelvic cavity. Its anteroposterior extensibility allowed effective filling of the defect. Advancement of the posterior portion of the muscle into the deep pelvis compensated for the limited pedicle length. Preservation of the motor nerve may have helped maintain muscle volume, particularly on the intrapelvic side, with minimal postoperative atrophy observed. These technical strategies demonstrate that the pedicled vastus lateralis myocutaneous flap provides adequate volume, reach, and durability, and may represent a valuable option for extensive pelvic floor reconstruction, especially when motor innervation is preserved.