Comparison of V-Y Advancement Flap Versus Lotus Petal Flap for Plastic Reconstruction After Surgery in Case of Vulvar Malignancies: A Retrospective Single Center Experience

Abstract: Vulvoperineal defects after demolitive surgery for preneoplastic or malignant vulvar lesions require a reconstruction to restore good sexual functions and to offer a satisfactory cosmetic result. Several techniques of reconstruction have been described in the past, leading to a more conservative and localized treatment. This study retrospectively reviewed patients with primary or recurrent vulvar malignancies that had undergone vulvoperineal reconstruction between 2010 and 2016 using the V-Y advancement flap and the 2 variant of the lotus petal flap (LPF) in terms of surgical outcome and postoperative complications. Two hundred eighty-four (284) women were reviewed, 234 of them having undergone V-Y flap and 128, the LPF. Overall, postoperative complications occurred in 21.5% of patients including 21% (27/128) of the V-Y group and in 13% (14/106) of the LPF group. The 2 techniques are valid and feasible for vulvar reconstruction in case of moderate defects. No statistically significant differences in terms of complications were observed between the 2 groups overall (P = 0.588), or by comparing the primary (P = 0.202) or the recurrent setting (P = 0.281). Lotus petal flap, particularly the tunneled variant, was superior to V-Y advancement flap in terms of functional and cosmetic results in patients undergoing resection for primary vulvar malignancies.

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