<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022015000400200</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Resección abdominoperineal isquioanal con reconstrucción de pared posterior de vagina con colgajo miocutáneo de músculo recto abdominal vertical]]></article-title>
<article-title xml:lang="en"><![CDATA[Ischioanal abdominoperineal resection with reconstruction of posterior wall of vagina with vertical rectus abdominis myocutaneous flap]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivera-Chavarría]]></surname>
<given-names><![CDATA[José P.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Murillo-Rodriguez]]></surname>
<given-names><![CDATA[José E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas-Villalobos]]></surname>
<given-names><![CDATA[Alfredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,joseriverach@gmail.com Unidad de Cirugía de Colon y Recto Servicio de Cirugía General]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,aff2  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2015</year>
</pub-date>
<volume>57</volume>
<numero>4</numero>
<fpage>200</fpage>
<lpage>203</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022015000400200&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022015000400200&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022015000400200&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[El colgajo del recto abdominal miocutáneo vertical, es un excelente colgajo que rellena el gran defecto en la pelvis luego de una resección abdominoperineal isquioanal, siendo libre de tensión y reduciendo significativamente la incidencia de complicaciones de la herida perineal y la estancia hospitalaria, con el cual se puede reconstruir la pared posterior de la vagina. Se reporta aquí el primer caso en Costa Rica de una resección abdominoperineal isquioanal, con reconstrucción de pared posterior de vagina con colgajo del recto abdominal miocutáneo vertical, practicada con éxito en una paciente de 62 años, con un adenocarcinoma rectal localmente avanzado con infiltración de pared posterior de vagina.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Vertical rectus abdominis myocutaneous flap, is an excellent flap that fills the large defect in the pelvis after an adominoperineal ischioanal resection; it is free from tension, significantly reduces the incidence of perineal wound complications and hospital stay and can be used to reconstruct the posterior wall of the vagina. We report the first case of Costa Rica abdominoperineal ischioanal resection with reconstruction of posterior vaginal wall with vertical rectus abdominis myocutaneous flap, successfully practiced in a patient of 62 years with locally advanced rectal adenocarcinoma infiltrating posterior wall of the vagina.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[tumoración rectal]]></kwd>
<kwd lng="es"><![CDATA[exanteración pélvica]]></kwd>
<kwd lng="es"><![CDATA[resección abdominoperineal]]></kwd>
<kwd lng="es"><![CDATA[colgajo miocutáneo de músculo recto abdominal vertical]]></kwd>
<kwd lng="en"><![CDATA[Rectal tumor]]></kwd>
<kwd lng="en"><![CDATA[pelvic exenteration]]></kwd>
<kwd lng="en"><![CDATA[abdominoperineal resection]]></kwd>
<kwd lng="en"><![CDATA[vertical rectus abdominis myocutaneous flap]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vertical rectus abdominis myocutaneous flap reconstruction of the perineal defect after abdominoperineal excision is associated with low morbidity.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barker]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Branagan]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Crick]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[McGuiness]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Chave]]></surname>
<given-names><![CDATA[H.]]></given-names>
</name>
</person-group>
<source><![CDATA[Colorectal Dis.]]></source>
<year>2013</year>
<volume>15</volume>
<page-range>1177-83.</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Perineal healing and survival after anal cancer salvage surgery: 10-year experience with primary perineal reconstruction using the vertical rectus abdominis myocutaneous (VRAM) flap.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sunesen]]></surname>
<given-names><![CDATA[KG]]></given-names>
</name>
<name>
<surname><![CDATA[Buntzen]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tei]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Lindegaard]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Nørgaard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Laurberg]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Surg Oncol.]]></source>
<year>2009</year>
<volume>16</volume>
<page-range>68-77</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Female sexual function after abdominoperineal resection for squamous cell carcinoma of the anus and the specific influence of colpectomy and vertical rectus abdominis myocutaneous flap.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Corte]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Lefèvre]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Dehnis]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Shields]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Chaouat]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tiret]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Colorectal Dis.]]></source>
<year>2011</year>
<volume>13</volume>
<page-range>774-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A hundred patients with vertical rectus abdominis myocutaneous (VRAM) flap for pelvic reconstruction after total pelvic exenteration.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Horch]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Hohenberger]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Eweida]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kneser]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Weber]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Arkudas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Int J Colorectal Dis.]]></source>
<year>2014</year>
<volume>29</volume>
<page-range>813-23.</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Perineal reconstruction using pedicled vertical rectus abdominis myocutaneous flap (VRAM).]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Touny]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Othman]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Maamoon]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ramzy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Elmarakby]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<source><![CDATA[J Surg Oncol.]]></source>
<year>2014</year>
<volume>110</volume>
<page-range>752-7</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Use of myocutaneous flaps for perineal closure following abdominoperineal excision of the rectum for adenocarcinoma.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ng]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ross]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Roblin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Carapeti]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Colorectal Dis.]]></source>
<year>2010</year>
<volume>12</volume>
<page-range>555-60.</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Outcomes of immediate vertical rectus abdominis myocutaneous flap reconstruction for irradiated abdominoperineal resection defects.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Butler]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
<name>
<surname><![CDATA[Gündeslioglu]]></surname>
<given-names><![CDATA[AO]]></given-names>
</name>
<name>
<surname><![CDATA[Rodriguez-Bigas]]></surname>
<given-names><![CDATA[MA.]]></given-names>
</name>
</person-group>
<source><![CDATA[J Am Coll Surg.]]></source>
<year>2008</year>
<volume>206</volume>
<page-range>694-703.</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Abdomino-perineal resection for anal cancer: impact of a vertical rectus abdominis myocutaneus flap on survival, recurrence, morbidity, and wound healing.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lefevre]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Parc]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Kernéis]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Shields]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Touboul]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Chaouat]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Surg.]]></source>
<year>2009</year>
<volume>250</volume>
<page-range>707-11.</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vertical rectus abdominis myocutaneous flap and quality of life following abdominoperineal excision for rectal cancer: a multi-institutional study.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[O'Dowd]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Burke]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Condon]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Waldron]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ajmal]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Deasy]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Tech Coloproctol.]]></source>
<year>2014</year>
<volume>18</volume>
<page-range>901-6.</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A prepelvic tunnel for the rectus abdominis myocutaneous flap in perineal reconstruction.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Warrier]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Solomon]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
</person-group>
<source><![CDATA[J Plast Reconstr Aesthet Surg.]]></source>
<year>2006</year>
<volume>59</volume>
<page-range>1415-9.</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[How should perineal wounds be closed following abdominoperineal resection in patients post radiotherapy--primary closure or flap repair? Best evidence topic (BET).]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Howell]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Jarral]]></surname>
<given-names><![CDATA[OA]]></given-names>
</name>
<name>
<surname><![CDATA[Faiz]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Ziprin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Darzi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Zacharakis]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Int J Surg.]]></source>
<year>2013</year>
<volume>11</volume>
<page-range>514-7.</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vulvo-perineal reconstruction with a reverse sensitive rectus abdominis salvage flap in a multirecurrent anal carcinoma.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Di Benedetto]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Siquini]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Bertani]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Grassetti]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<source><![CDATA[J Plast Reconstr Aesthet Surg.]]></source>
<year>2010</year>
<volume>63</volume>
<page-range>e127-9.</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Use of adjuvant techniques improves surgical outcomes of complex vertical rectus abdominis myocutaneous flap reconstructions of pelvic cancer defects.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campbell]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Butler]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
</person-group>
<source><![CDATA[Plast Reconstr Surg.]]></source>
<year>2011</year>
<volume>128</volume>
<page-range>447-58.</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Modified vertical rectus abdominis myocutaneous flap vaginal reconstruction: an analysis of surgical outcomes]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berger]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Westin]]></surname>
<given-names><![CDATA[SN]]></given-names>
</name>
<name>
<surname><![CDATA[Fellman]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Rallapali]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Frumovitz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ramirez]]></surname>
<given-names><![CDATA[PT]]></given-names>
</name>
</person-group>
<source><![CDATA[Gynecol Oncol.]]></source>
<year>2012</year>
<volume>125</volume>
<page-range>252-.</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Daigeler]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Simidjiiska-Belyaeva]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Drücke]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Goertz]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Hirsch]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Soimaru]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Langenbecks Arch Surg.]]></source>
<year>2011</year>
<volume>396</volume>
<page-range>1271-9.</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
