Clinical and surgical aspects of vulvar reconstruction with tensor fasciae latae flaps after en bloc radical vulvectomy.


PURPOSE The aim of this study was to assess some clinico-surgical aspects of vulvar reconstruction with m. tensor fasciae latae flaps (TFL). PATIENTS AND METHODS This retrospective study covers the period 1996-2002, and 51 patients with vulvar carcinoma were analyzed. Seven (13.7%) patients had undergone en bloc resection, followed by vulvar reconstruction with TFL., 28 (54.9%) radical vulvectomy with bilateral inguinofemoral lymph node dissection, and 12 (23.5%) patients simple vulvectomy. RESULTS In 13 (25.5%) patients recurrences were found, that could not be statistically related to the type of surgical intervention (p=0.47). The overall 2-year survival was 82%. Factors contributing to prognosis included FIGO stage, the presence of recurrence and its type. Nine (17.6%) patients had died and the distribution by type of surgery in that group was as follows: en bloc resection with TFL reonstruction--14.3%, radical vulvectomy with lymph node dissection--17.9%, and simple vulvectomy--25%. The correlation was statistically nonsignificant (p=0.71). CONCLUSION The comparison of the 3 surgical methods of treating primary vulvar carcinoma showed no influence on survival, mortality rate, and type and rate of recurrences. To obtain a reliable clinico-surgical assessment, a multicenter study is necessary.


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