Single-stage Abdominoplasty Using Groin Flaps Without Osteotomies: Management of Exstrophy-epispadias Complex

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGIRON, Amilcar Martins
dc.contributor.authorMELLO, Marcos Figueiredo
dc.contributor.authorBERJEAUT, Ricardo Haidar
dc.contributor.authorMACHADO, Marcos Giannetti
dc.contributor.authorSILVA, Gabriel Carvalho dos Anjos
dc.contributor.authorCEZARINO, Bruno Nicolino
dc.contributor.authorOLIVEIRA, Lorena Marcalo
dc.contributor.authorLOPES, Roberto Iglesias
dc.contributor.authorDENES, Francisco Tibor
dc.date.accessioned2019-01-17T13:39:12Z
dc.date.available2019-01-17T13:39:12Z
dc.date.issued2018
dc.description.abstractBACKGROUND The optimal treatment for children born with exstrophy-epispadia complex is still a matter of AND OBJECTIVE debate.(1,2,3) We demonstrate the Single-Stage Abdominoplasty using Groin Flap technique to close the abdominal wall of children with classic bladder exstrophy (CBE) without osteotomy neither radical soft tissue mobilization. Advantages over current techniques are less risk of penile tissue loss and avoidance of osteotomies. MATERIAL AND METHODS Abdominal wall repair consists in using the hypogastric skin, rectus, and obliquus externus abdom inalis muscle fascial flaps. These groin flaps are rotated medially resulting in a very strong abdominal wall support. Groin flaps are made of rectus anterior fascia rotated medially, flipped over, and sutured with Prolene sutures to close the defect. By rotating the fascial flaps medially, complete reinforcement of the abdominal wall to the level of the pubic bone is achieved. This permits abdominal closure maintenance without tension. RESULTS Groin flap was applied to 128 patients with CBE referenced from all over the country. Most of these patients returned to their home areas making difficult their follow up. However, we have 44 cases that have regular clinical visits. Mean follow-up was 10.3 4.5 years (2 years 8 months-16 years). Successful closure was achieved in 43 patients (97.7%) as a single procedure; one patient had a complete wound dehiscence and needed another reconstruction (2.2%). Four patients (9.1%) presented abdominal hernias that needed surgical management. When continence is evaluated, we present similar literature rates (60%).(4) CONCLUSION Abdominal reconstruction using Groin flaps has advantages over the traditional approaches to CBE. It reduces the surgical steps and facilitates the closure of the abdominal wall without the need of osteotomies and consequent immobilization during the postoperative period. It is feasible at any age and can be also very useful as a salvage technique even after previous failed procedures. Finally, it minimizes the number of surgeries. (C) 2018 Elsevier Inc.eng
dc.description.indexMEDLINEeng
dc.identifier.citationUROLOGY, v.120, p.266-266, 2018
dc.identifier.doi10.1016/j.urology.2018.07.001
dc.identifier.eissn1527-9995
dc.identifier.issn0090-4295
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/30174
dc.language.isoeng
dc.publisherELSEVIER SCIENCE INCeng
dc.relation.ispartofUrology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright ELSEVIER SCIENCE INCeng
dc.subject.otherbladder exstrophyeng
dc.subject.wosUrology & Nephrologyeng
dc.titleSingle-stage Abdominoplasty Using Groin Flaps Without Osteotomies: Management of Exstrophy-epispadias Complexeng
dc.typearticleeng
dc.type.categoryeditorial materialeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcAMILCAR MARTINS GIRON
hcfmusp.contributor.author-fmusphcMARCOS FIGUEIREDO MELLO
hcfmusp.contributor.author-fmusphcRICARDO HAIDAR BERJEAUT
hcfmusp.contributor.author-fmusphcMARCOS GIANNETTI MACHADO
hcfmusp.contributor.author-fmusphcGABRIEL CARVALHO DOS ANJOS SILVA
hcfmusp.contributor.author-fmusphcBRUNO NICOLINO CEZARINO
hcfmusp.contributor.author-fmusphcLORENA MARCALO OLIVEIRA
hcfmusp.contributor.author-fmusphcROBERTO IGLESIAS LOPES
hcfmusp.contributor.author-fmusphcFRANCISCO TIBOR DENES
hcfmusp.description.beginpage266
hcfmusp.description.endpage266
hcfmusp.description.volume120
hcfmusp.origemWOS
hcfmusp.origem.pubmed30031829
hcfmusp.origem.scopus2-s2.0-85056419788
hcfmusp.origem.wosWOS:000448386300054
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUSAeng
hcfmusp.relation.referenceGearhart J P, 1999, Curr Opin Urol, V9, P499, DOI 10.1097/00042307-199911000-00002eng
hcfmusp.relation.referenceGiron AM, 2017, INT BRAZ J UROL, V43, P155, DOI [10.1590/s1677-5538.ibju.2015.0581, 10.1590/S1677-5538.IBJU.2015.0581]eng
hcfmusp.relation.referenceInouye BM, 2014, SURG RES PRACT, V2014eng
hcfmusp.relation.referenceMitchell ME, 2005, UROLOGY, V65, P5, DOI 10.1016/j.urology.2004.07.030eng
hcfmusp.scopus.lastupdate2024-05-10
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