Often, the only way to eradicate rectal cancer is by completely removing the rectum, anus, and colon. While this surgical procedure can be life-saving, it also comes with some significant complications. Most notably, it leaves a significant wound. At Thrive Reconstructive Surgery, we perform full rectal cancer reconstruction procedures for patients. Our practices are ready to serve you.
Perineal Reconstruction Explained
One of the most common treatments for rectal cancer is abdominoperineal resection, or APR. In this procedure, the surgeon may remove the anus, rectum, and sigmoid cancer; this can be the only way to ensure all cancerous tissue is eradicated from the body. This procedure leaves a major perineal wound, which our surgeons can reconstruct using a skin flap.
While there are several different kinds of skin flaps that may be used, the most common option is what is known as the Vertical Rectus Abdominis Musculocutaneous (VRAM) flap. This kind of flap requires the plastic surgeon to make a vertical incision in the abdomen to remove the rectus abdominis muscle, as well as the tissue that lies on top of it. The flap is then rotated into the perineum (the area between the anus and the scrotum or vulva), where it can be sutured into place.
The VRAM flap tends to be an effective post-cancer reconstructive surgery option because it ensures enough mass to fill the large wound, and the overlying skin allows for the wound to be completely closed.
What is a Muscle Flap?
A flap is a piece of tissue taken from one area (donor site) and transferred to another (recipient site). A flap is different from a skin graft in that it maintains its own blood supply. This blood supply allows the flap to be moved from one area to another and survive. Flaps can be classified based on several factors, including blood supply, tissue composition, and donor site.
A free flap involves complete removal of the tissue from the donor site and placing it onto the defect. A free flap is the most complex type of flap as it requires microsurgery to connect the blood vessels of the flap to the vessels of the recipient site.
A pedicled flap maintains direct connection to the donor site and is stretched to cover the defect.
Depending on where the wound is and how large the defect is, different tissue types may be used. Some of the commonly used tissue types are as follows:
Cutaneous flaps involve only the skin and superficial fascia and are used on small defects.
Fasciocutaneous flaps involve the skin, subcutaneous tissue, and deep fascia and provide a better blood supply.
Musculocutaneous flaps contain the skin, subcutaneous tissue, fascia, and muscle. The added muscle allows you to fill a larger defect.
Muscle flaps contain muscle only and allow for the functionality of the muscle at the recipient site. Because this type of flap does not include skin, a skin graft can also be placed to cover the site.
Who is a Candidate for Post-Rectal Cancer Reconstructive Surgery?
Not everyone who is treated for rectal cancer requires follow-up surgery for reconstruction.
However, if you have had your rectum removed and are left with a significant wound, post-cancer reconstructive surgery can help you regain the regular functionality of your body. It can also help you regain some self-confidence and avoid awkwardness and embarrassment during intimate moments.
If you have had your rectum and anus removed but are unsatisfied with how your wound site was closed or healed, you may be a good candidate for post-rectal cancer reconstruction.
Additionally, if your rectal cancer treatment leaves you with significant scarring, resulting in pain or discomfort, we would encourage you to reach out to Thrive Reconstructive Surgery. We would love to explain some of your treatment options.
Meet Your Post-Cancer Reconstruction Surgeons
At Thrive Reconstructive Surgery, we are known for our willingness to accept the hardest cases and the most challenging pathologies. Our reconstructive surgeons are known as problem-solvers and go-to specialists for referring doctors.
Our areas of specialty include treatment for rectal cancer, skin cancer, hardware infection, facial trauma, and beyond. We aim to provide each patient with expert care, helping them fully regain the aesthetics, mobility, and functionality of their body.
In addition to muscle flaps, skin grafts can also prove useful in post-rectal cancer reconstruction. Essentially, a skin graft involves a surgeon removing the top layer of skin from one part of the body and transplanting it to another part of the body. Skin grafts can sometimes be used to cover the wounds left by rectal cancer treatment.
The type of surgery we recommend will depend on numerous factors, including the size of the wound left behind by your rectal cancer treatment. When you join us for an initial consultation, we can talk with you further about the specific procedure that we think will be needed.
Post-rectal cancer reconstruction procedures are always performed when the client is under anesthesia. Your plastic surgeon may take skin or muscle from a donor site, carefully removing it from the body and creating a flap or graft to mask the wound.
The flap or graft may be adhered to the wound site using staples, stitches, or other means, ensuring that it heals properly and that new blood vessels may grow, attaching the transplant to the wound site.
No matter which type of reconstruction we perform, the goal is always to restore the patient to full functionality, mobility, and confidence in their physical appearance.
Post-Surgery and Recovery
Depending on the type of surgery that is performed, the timeline for recovery can vary. Our surgeons will talk to you about the recovery process before your procedure at our DFW location. We detail your expected recovery time, explain how to manage any pain or discomfort, and clarify any limitations to your daily routine.
In rare circumstances, a person may have to make permanent lifestyle adjustments, which can be further outlined by your surgeon. With that said, surgical techniques have advanced to the point that most rectal cancer patients do not require the permanent use of colostomy bags. Most patients are able to resume their normal life and activities after allowing a few weeks for the wounds to heal and their bodies to recover.
Thrive Reconstructive Surgery works to ensure that each post-rectal cancer reconstruction patient returns to the normal functionality of their body in as little time as possible. With any additional concerns about the recovery process, we invite you to contact us directly.
Reconstruction After Rectal Cancer
For those who are diagnosed with rectal cancer, removal of the rectum, anus, and colon may be necessary, life-saving measures. With the right reconstructive care, you can go on with your life, enjoying the normal functionality of your body.
To find out more about post-rectal cancer reconstruction, reach out to Thrive Reconstructive Surgery at your next opportunity. You can learn about your treatment options in a consultation with one of our surgeons. Request an appointment online today.