Article Text

Download PDFPDF

2022-RA-1518-ESGO Role of Plastic surgery following resection of vulval tumours: Is collaboration the key?
Free
  1. Maneesh Singhal1,
  2. Seema Singhal2,
  3. Shashank Chauhan1,
  4. Suvashis Dash1,1,
  5. Suvashis Dash1,1,
  6. Shivangi Saha2,
  7. Shruthi Chandrasekar1,
  8. Nandini Singh1,
  9. Amit Mandal2,
  10. Anju Singh2,
  11. Neena Malhotra2 and
  12. Neerja Bhatla2
  1. 1Plastic and Reconstructive Surgery, All India Institute of Medical Sciences, New Delhi, India
  2. 2Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India

Abstract

Introduction/Background Reconstruction of the vulva following extirpative surgeries is essential in restoring the form and functions of daily living. Complex defect reconstruction can be difficult and may necessitate collaboration between gynaecology and reconstructive surgeons. We present our experience in the reconstruction of vulval defects following tumour excision (benign and malignant) and in the management of post inguinal lymph node dissection (ILND) lymphorroea.

Methodology A prospective study was conducted between 2020–2022. All patients (N=8) requiring plastic surgical intervention were included. Five patients with vulval tumours underwent reconstruction. Three patients having ILND lymphorrhoea and other malignant vulval tumours were managed conservatively with low pressure negative wound therapy (NPWT).

Results The median age was 50.4 years (28–63 years), requiring a mean hospital stay of 13.6 days. Two cases of vulval squamous cell carcinoma underwent local V-Y advancement flap and a pedicled anterolateral thigh flap, respectively. One case of primary vulval lymphedema was managed with debulking and reconstruction of the labia majora and minora with vulval flaps. Two benign tumours of the vulva (fibromatosis) required W-plasty and V-Y advancement flap respectively.One patient had vaginal wall necrosis and partial flap dehiscence in the immediate post-operative period. No long-term delayed complications were observed in our patients at a mean follow-up of 3 months. The mean length of hospital stay for inguinal lymphorrhoea was not significantly higher than that for those undergoing reconstructive surgery.

Conclusion Reconstructive surgery improves pain, function, and early postoperative recovery. Application of NPWT is an effective modality for treating inguinal lymphorrhoea. Collaboration with the plastic surgery team is essential in achieving the same for the benefit of such patients.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.