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Treatment of a chronic vesicocutaneous fistula and abdominal wall defect after resection of a soft tissue sarcoma using a bipedicled latissimus dorsi and serratus anterior free flap.
[liposarcoma]
We
present
a
surgical
treatment
for
bladder
reconstruction
in
a
case
of
chronic
vesicocutaneous
radiation-induced
fistula
and
reconstruction
of
the
abdominal
wall
after
resection
of
a
liposarcoma
in
the
rectus
abdominis
muscle
.
Fistulas
are
sequelae
after
radiotherapy
.
To
regain
bladder
function
and
reconstitute
abdominal
wall
stability
,
a
microsurgical
flap
approach
should
be
considered
.
A
male
patient
underwent
resection
of
a
liposarcoma
in
the
rectus
abdominis
muscle
with
adjuvant
radiotherapy
,
suffering
from
a
chronic
vesicocutaneous
fistula
.
A
bipedicled
combined
latissimus
dorsi
and
serratus
anterior
flap
was
carried
out
after
resection
of
the
fistula
for
reconstruction
of
the
urine
bladder
and
the
abdominal
wall
.
Ascending
urethrography
4
weeks
postoperatively
showed
no
leakage
.
In
the
4
-
month
follow-up
period
,
no
signs
of
recurrence
of
the
fistula
or
herniation
occurred
.
A
bipedicled
flap
allowed
reconstruction
of
the
urine
bladder
and
the
abdominal
wall
.
Using
non-irradiated
,
well-perfused
intra-
abdominal
muscle
tissue
over
the
urine
bladder
prevented
recurrence
of
the
fistula
.
