<< Back to the abstract archive
Optimizing Outcomes in Hemipelvectomy Reconstruction with the Free Fillet of Leg Flap
Kristopher Katira MD, Navid Pourteheri, MD, PhD, Donald Harvey MD, Ashwath Gunasekar, Hooman Soltanian MD
University Hospitals Case Medical Center
2016-01-19
Presenter: Kristopher Katira MD
Affidavit:
75 percent of this project represents the original work of the resident.
Director Name: Hooman Soltanian MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Hemipelvectomy is a high level pelvic amputation, in which the half the pelvis and ipsilateral lower limb are removed. Hemipelvectomy reconstruction is often challenging, as critical neurovascular or muscle structures are often contained within the tumor or are sacrificed to obtain surgical margins. The free fillet flap is a powerful tool in the reconstruction of hemipelvectomy defects, especially for neoplasms in the proximal thigh/pelvis, when pedicled fillet flaps are not available and locoregional flaps do not offer adequate caliber of tissue. By providing a larger volume of tissue than other flaps, this "spare-parts" reconstruction offers patients better bulk for balance while sitting and while using a prosthesis. Only a small number of cases of free fillet of leg/thigh have been presented in the literature worldwide, and most of these are performed in large cancer hospitals. In this paper, we discuss several technical refinements of the fillet of leg/thigh flap, including videos of dissection steps, practical solutions for limiting ischemia time, a systematic approach for vessel selection, tips for collaboration with oncologic surgeons, and complications that can be avoided. The immediate and long-term outcomes of patients in our series is described.
