Biomedical subjects

P A Chretien

Publications and source records attributed to P A Chretien.

3 recordsLinked to original sources

PubMed1983

Hemipelvectomy for buttock tumors utilizing an anterior myocutaneous flap of quadriceps femoris muscle.

Hemipelvectomy utilizing an anterior myocutaneous flap is indicated for aggressive tumors of the buttock and proximal portion of the posterior thigh. A large operative defect created posteriorly by amputation of the lower extremity, hemipelvis, and buttock is covered by a myocutaneous flap of quadriceps femoris muscle and overlying skin and subcutaneous tissue. The superficial femoral artery is preserved to sustain the myocutaneous flap.

Adolescent↗

PubMed1982

A surgical technique for buttockectomy.

The buttockectomy is an en bloc resection of the gluteus maximus muscle and is usually performed for low-grade malignancy tumors of the buttocks that are encompassed by the muscle excised. After the incision of the skin widely around the tumor, skin flaps are created to expose the entire gluteus maximus muscle; the inferior rolled edge of the muscle is identified and traced laterally to its insertion on the iliotibial tract. For a left buttockectomy the operator proceeds clockwise, first releasing the insertions of the muscle from the iliotibial tract and greater trochanter and the origins from the crest of ilium and sacrum. For a right buttockectomy one proceeds in a counterclockwise fashion, again starting at the inferior aspect of the gluteus maximus muscle. Care must be taken to avoid damage to the sciatic nerve and to secure the inferior and superior gluteal vessels before they are transected. Suction drainage is secured to remove serum and ensure adherence of skin flaps to the resection site. If the skin closure is tight, retention sutures may be needed.

Buttocks↗

PubMed1981

Surgical technique of hemipelvectomy in the lateral position.

Hemipelvectomy is most frequently indicated for sarcoma of the upper thigh, hip, or pelvis. With the patient in the lateral position the incision is made through the anterior abdominal wall, and the iliac vessels are dissected free and divided just distal to the aortic bifurcation. The multiple visceral branches of the internal iliac vessels are divided and ligated to expose the sacral nerve roots deep within the pelvis. The posterior skin flap is dissected free and the gluteus maximus muscle severed from its origin on the sacrum. Back muscles are detached from the wing of the ilium and the psoas muscle with accompanying obturator and femoral nerves is divided. The pelvis begins to open as the symphysis pubis is divided. Next the sacral nerve roots are divided and anterior capsule of the sacroiliac joint. The muscles and ligaments of the pelvic floor are severed including the urogenital diaphragm, levator ani muscle, sacrotuberous ligament, and sacrospinalis ligament. The specimen is released by severing the sacroiliac joint posteriorly. The operative defect is closed by suturing gluteal fascia to inguinal ligament over suction drains.

Amputation, Surgical↗