Reconstrucción de defectos inguinales complejos con colgajo vram de pedículo inferior en cáncer de pene avanzado

OBJECTIVE: Penile cancer uncommon in developed countries. In underdeveloped countries, frequency increases by 10% - 20% of male malignancies. The principle of surgical management is resection with adequate margins, inguinal lymph node dissection if indicated. Lumpectomy with inguinal node dissection pelvic plus reconstruction with flaps in cases with extensive nodal disease and skin is a less studied therapeutic option. METHODS: Descriptive study analysis by simple percentages of the characteristics patients treated for cancer of penis progress in our institute, who underwent lumpectomy lymphadenectomy plus VRAM flap reconstruction. We collect information from medical records of patients admitted to this institution during the years 2005 2009. RESULTS: 3 patients with advanced penile carcinoma (ST IV lymph node) all T3-T4, N2-N3 and extensive skin disease. To underwent wide resection of primary lesion lymphadenectomy inguinopelvic plus VRAM flap reconstruction, there were complications such as lymphedema late manageable mild local infection, one patient died a year with metastases to brain, other locorregional relapse, eight months after one remains free of disease after 5 years of follow up. CONCLUSION: Radical resection in patients with penile carcinoma ST IV (Lymph node) plus inguinal and pelvic lymphadenectomy in which is significant skin defect that cannot be closed, we propose the use VRAM flap that although it has not been used in cancer the penis in our experience allowed a palliative effect, functional and aesthetically satisfactory locorregional control, in addition to providing the conditions for postoperative treatment.