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1060 The role of VY flap reconstruction in vulvar cancer patients: a multicenter retrospective study
  1. Violante Di Donato1,
  2. Andrea Giannini1,
  3. Valerio Galli1,
  4. Mariano Catello Di Donna2,
  5. Mario Antonio Congiu3,
  6. Giorgia Garganese4,
  7. Francesco Plotti5,
  8. Flavia Sorbi6,
  9. Tullio Golia D’Augè1,
  10. Antonio Simone Laganà7,
  11. Anna Amelia Caretto4,
  12. Ilaria Cuccu1,
  13. Francesca Falcone8,
  14. Mario Malzoni8,
  15. Enzo Ricciardi9,
  16. Giorgia Perniola1,
  17. Camilla Turetta1,
  18. Helmut Plett10,
  19. Massimiliano Fambrini6,
  20. Vito Chiantera7,
  21. Enrico Vizza11,
  22. Roberto Angioli5,
  23. Francesco Raspagliesi12,
  24. Ludovico Muzii1,
  25. Giovanni Scambia4,
  26. Pierluigi Benedetti Panici1 and
  27. Giorgio Bogani12
  1. 1Department of Gynecological, Obstetrical and Urological Sciences, ‘Sapienza’ University of Rome, Rome, Italy
  2. 2Unit of Gynecologic Oncology, ARNAS ‘Civico-Di Cristina-Benfratelli’, University of Palermo, Palermo, Italy
  3. 3Chirurgien gynéco-oncologique Clinique Champeau Méditerranée et Clinique Causse Béziers et Colombiers, Béziers, France
  4. 4Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  5. 5Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
  6. 6Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynecology, University of Florence, Florence, Italy
  7. 7Unit of Gynecologic Oncology, ARNAS ‘Civico-Di Cristina-Benfratelli’, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
  8. 8Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, Avellino, Italy, Avellino, Italy
  9. 9Gynecologic Oncology Unit, Department of Ostetrica and Gynecology, Ospedale Sandro Pertini, Rome, Italy
  10. 10Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
  11. 11Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCSS-Regina Elena National Cancer Institute, Rome, Italy, Rome, Italy
  12. 12Fondazione IRCCS Istituto Nazionale dei Tumori, Gynecological Oncology Unit, Milan, Italy


Introduction/Background The aim of present multicenter retrospective controlled study is to assess the feasibility and safety of the modified V-Y advancement gluteal flap in the vulvo-perineal reconstruction among women operated for vulvar malignancies.

Methodology A multi-institutional retrospective study compared surgical outcomes and complication rates of women with invasive vulvar cancer who underwent radical surgery and vulvar reconstruction with those of a control group of women who underwent radical surgery without the reconstruction step. In the present series, only patients who underwent bilateral or monolateral V-Y advancement fascia-cutaneous flap were included in the reconstruction group. Univariate and multivariate logistic regression model was used to analyze predicting variables for their association with complication rate.

Results Three hundred sixty-one patients surgically treated for vulvar cancer were evaluated. Overall, 190 (52%) underwent the reconstructive step after the demolition procedure and were compared with 171 (47.4%) patients who did not undergo the reconstructive step. At multivariate analysis, BMI>30 (OR 3.36; p=0.007), diabetes (OR 2.62, p<0.022), were independently correlated with wound infection. Moreover, increasing age (OR 1.52, p=0.009), BMI> 30 (OR 3.21, p=0.002), advanced stage (III-IV FIGO) (OR 2.25, p=0.017) were independent predictors of wound dehiscence. Moreover, a significant reduction in the incidence of post-operative wound complications among patients who underwent reconstructive procedures was demonstrated. This was correlated more significantly in women affected by tumor lesions larger than 4 cm.

Conclusion The rate of vulvar surgical-related morbidity is significantly influenced by the stage at diagnosis, the extent of surgery, and existing medical conditions (BMI and Obesity), including preoperative comorbidities. The adoption of V-Y fascia-cutaneous flaps in vulvar surgery seems to be significantly correlated with a reducing surgical related complication, particularly in vulnerable patient cases involving large surgical defects following demolitive procedures.

Disclosures None.

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