Experience of Reconstruction Using Myocutaneous Flaps in Surgery for Penile Cancer locoregionally Advanced Treatment at Haroldo Juaçaba Hospital

Abstract

Introduction: There is very high incidence ~of penile cancer in Brazil. Most patients are diagnosed early but one third present with advanced local or regional disease. In cases of major resection with substantial loss of tissue, musculocutaneous flaps may be necessary. Objective: to identify the most used types of flaps and their associated major complications in the reconstruction of complex defects following surgery for locoregionally advanced penile cancer at a Brazilian referral center. Method: A retrospective, observational and descriptive study involving 243 patients treated for penile cancer at Haroldo Juacaba Hospital (Fortaleza, Brazil) between January 2000 and September 2010 of which 35 required reconstruction with surgical flaps. Results: The myocutaneous rectus abdominis flap was the most frequently used (57.2%), followed by the fascia lata flap (31.4%) and the gracilis flap (11.4%). The most common early complications were infection of the surgical wound (37.1%) and partial flap dehiscence (37.1%). The most common late complications were chronic lymphedema (32.3%) and scrotal swelling (29.4%). Conclusion: The myocutaneous rectus abdominis flap was the most frequently used and was found to be safe. The techniques evaluated in this study were associated with significant levels of morbidity which did not compromise flap viability.