1060 The role of VY flap reconstruction in vulvar cancer patients: a multicenter retrospective study

Introduction/Background The aim of present multicenter retrospective controlled study is to assess the feasibility and safety of the modified V-Y advancement gluteal flap in the vulvo-perineal reconstruction among women operated for vulvar malignancies. Methodology A multi-institutional retrospective study compared surgical outcomes and complication rates of women with invasive vulvar cancer who underwent radical surgery and vulvar reconstruction with those of a control group of women who underwent radical surgery without the reconstruction step. In the present series, only patients who underwent bilateral or monolateral V-Y advancement fascia-cutaneous flap were included in the reconstruction group. Univariate and multivariate logistic regression model was used to analyze predicting variables for their association with complication rate. Results Three hundred sixty-one patients surgically treated for vulvar cancer were evaluated. Overall, 190 (52%) underwent the reconstructive step after the demolition procedure and were compared with 171 (47.4%) patients who did not undergo the reconstructive step. At multivariate analysis, BMI>30 (OR 3.36; p=0.007), diabetes (OR 2.62, p<0.022), were independently correlated with wound infection. Moreover, increasing age (OR 1.52, p=0.009), BMI> 30 (OR 3.21, p=0.002), advanced stage (III-IV FIGO) (OR 2.25, p=0.017) were independent predictors of wound dehiscence. Moreover, a significant reduction in the incidence of post-operative wound complications among patients who underwent reconstructive procedures was demonstrated. This was correlated more significantly in women affected by tumor lesions larger than 4 cm. Conclusion The rate of vulvar surgical-related morbidity is significantly influenced by the stage at diagnosis, the extent of surgery, and existing medical conditions (BMI and Obesity), including preoperative comorbidities. The adoption of V-Y fascia-cutaneous flaps in vulvar surgery seems to be significantly correlated with a reducing surgical related complication, particularly in vulnerable patient cases involving large surgical defects following demolitive procedures. Disclosures None.