ABSTRACT Purpose: Reviewing surgical procedures using fasciocutaneous and myocutaneous flaps for inguinal reconstruction after lymphadenectomy in metastatic penile cancer. Material and Methods: We reviewed the current literature of the Pubmed database according to PRISMA guidelines. The search terms used were “advanced penile cancer”, “groin reconstruction”, and “inguinal reconstruction”, both alone and in combination. The bibliographic references used in the selected articles were also analyzed to include recent articles into our research. Results: A total of 54 studies were included in this review. About one third of penile cancers are diagnosed with locally advanced disease, often presenting with large lymph node involvement. Defects in the inguinal region resulting from the treatment of metastatic penile cancer are challenging for the surgeon and cause high patient morbidity, rendering primary closure unfeasible. Several fasciocutaneous and myocutaneous flaps of the abdomen and thigh can be used for the reconstruction of the inguinal region, transferring tissue to the affected area, and enabling tensionless closure. Conclusions: The reconstruction of defects in the inguinal region with the aid of flaps allows for faster postoperative recovery and reduces the risk of complications. Thus, the patient will be able to undergo potential necessary adjuvant treatments sooner.

Um dos maiores problemas dos pacientes pós-cirurgia bariátrica é o excedente de pele nas regiões glútea e lombar. Somado a isso, há escassez de tecido para preencher a região glútea, que pode ser corrigida por vários métodos, entre eles a lipoenxertia ou, ainda, o implante de prótese isoladamente, nos casos em que não haja ptose. Se o contrário ocorre, essas opções tornam-se muito limitadas e pouco expressivas. O lifting glúteo com emprego de retalho fasciocutâneo em cambalhota permite resolver tanto a flacidez como o excesso de pele com ptose. Este trabalho tem por objetivo demonstrar a facilidade de confecção e a versatilidade de utilização do retalho glúteo em cambalhota para correção de flacidez das regiões glútea e lombar. Uma paciente foi submetida ao procedimento cirúrgico de lifting glúteo associado ao emprego de retalho fasciocutâneo desepidermizado em cambalhota, para correção de falta de preenchimento local. Melhora acentuada das regiões glútea e lombar foi obtida após a retirada do excesso de tecido superior, confecção de um retalho fasciocutâneo de pedículo inferior e tração da pele. Além disso, a rotação do retalho e sua fixação ao músculo glúteo melhoraram acentuadamente o contorno posterior da paciente, com pós-operatório bastante cômodo. Com morbidade mínima, foi retirado o excesso cutâneo e, concomitantemente, aumentada a região glútea com retalho autólogo, que é desprezado durante a execução de muitas técnicas, melhorando o contorno da paciente e deixando uma cicatriz discreta, que poderá ser ocultada pelas roupas íntimas.

A major problem for patients after bariatric surgery is the excess skin in the gluteal and lumbar regions. In addition, there is a lack of available tissue to fill the gluteal region, which can be overcome by various methods, including fat grafting or even prosthesis implantation alone, in cases where no ptosis is noted. However, if this is not the case, the options become very limited and those available are not very effective. The use of a buttock lift with a fasciocutaneous flap solves the problems of sagging and excess skin with ptosis. In the present article, we aimed to demonstrate the ease of preparation and the versatility of use of the gluteal flap to correct sagging of the lumbar and gluteal regions. One patient underwent a buttock lift using a de-epidermized fasciocutaneous flap to overcome the lack of local filling. Marked improvement of the gluteal and lumbar regions was noted after removal of the excess tissue, construction of an inferior fasciocutaneous flap, and use of skin traction. In addition, rotation of the flap and its attachment to the gluteal muscle markedly improved the patient's posterior contour and postoperative comfort. With minimal morbidity, excess skin was removed and the gluteal region was concomitantly increased using an autologous flap that is neglected in many techniques; this resulted in an improved contour and a discreet scar that could be hidden by the patient's underwear.