Uterine Retroversion for Vaginoperineal Reconstruction Following Resection of Distal Rectal Tumors

• Published in: Diseases of the colon & rectum Vol. 53; no. 3; pp. 350 - 354
• Main Authors: Castillo, P A, Aguilar, V C, Wexner, S, Davila, G W
• Format: Journal Article
• Language: English
• Published: Hagerstown, MDc The ASCRS 01.03.2010; Lippincott Williams & Wilkins
• Subjects: Adenocarcinoma - surgery; Adult; Biological and medical sciences; Carcinoma, Squamous Cell - surgery; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; Perineum - surgery; Reconstructive Surgical Procedures - methods; Rectal Neoplasms - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Treatment Outcome; Tumors; Uterus - surgery; Vagina - surgery; Acquired vaginal defects; Distal rectal tumors; Vagina; Uterine retroversion; Surgical resection; Abdominoperineal resection; Rectal tumor; Local vaginal invasion; Invasion; Treatment; Uterus; Surgery; Gastroenterology; Posterior; Digestive diseases; Intestinal disease; Vaginal reconstruction; Posterior vaginectomy; Anorectal disease
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/DCR.0b013e3181c52d1d

PURPOSE:Vaginal and perineal reconstruction following wide resection of locally invasive rectal cancer can be challenging. Various techniques have been reported, all of which contribute the additional morbidity inherent in tissue procurement. We present a technique applicable to nonhysterectomized patients who undergo posterior vaginal wall reconstruction with retroversion of the in situ uterus. METHODS:Four nonhysterectomized patients with recurrent rectal carcinoma and abdominoperineal resection with en bloc resection of the posterior vagina leaving a large defect necessitating reconstruction of the vagina, perineum, or both, have undergone posterior vaginal wall and perineal reconstruction with uterine retroversion into the posterior pelvis and fixation to the perineum. RESULTS:Satisfactory vaginoperineal reconstruction was achieved in all our patients at 3 months. In addition, patients are able to resume sexual activity after tissue re-epithelialization. CONCLUSION:Uterine retroversion is a viable option for vaginal and perineal reconstruction.