1021 V-y flap reconstruction for vulvar cancer recurrence after primary radiotherapy

Introduction/Background* Vulvar cancer is a rare disease specially in young women. When a large tumour is diagnosed, reconstruction flap should be considered in order to achieve the best cosmetic and functional result. Methodology This surgical video shows the excision of a perianal recurrence secondary to a vulvar cancer after primary radiotherapy. Rectal amputation and terminal colostomy were performed through a laparoscopic approach. A bilateral V-Y flap was designed for perineal reconstruction. This procedure was recorded step by step. Result(s)* A 47 years old woman was diagnosed with perianal VIN III. It measured 25mm and had no extraperineal disease. Primary radiotherapy was indicated due to the invasion of anal mucosa. After 6 months of treatment, perianal recurrence of scamous vulvar carcinoma was diagnosed. Consequently, wide surgical excision, anal amputation, bilateral V-Y flap reconstruction and terminal colostomy were performed under lithotomy position and general anaesthesia. Despite surgical wound infection by pseudomonas and partial dehiscence, very good cosmetic and functional results were achieved. Conclusion* V-Y flap reconstruction may be a good option for the treatment of perineal defects that are too large for primary intention wound closure.