M L Ramos

Publications (2)3.69 Total impact

• Article: V--Y flap for perineal reconstruction following modified approach to vulvectomy in vulvar cancer.

  F Carramaschi, M L Ramos, A C Nisida, M C Ferreira, J A Pinotti
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  ABSTRACT: To evaluate a simple reconstructive procedure used in combination with a modified oncological approach to the treatment of invasive vulvar cancer. Local and systemic morbidity, length of hospital stay, local recurrence, and mortality were evaluated. Between September 1995 and January 1997, 19 patients underwent radical vulvectomy and inguinal lymphadenectomy with a modified oncological approach. The modified approach consisted of a triple incision: two inguinal incisions, shorter and following force lines of the groin, and a third incision around the vulvar lesion. Vulvectomy included a 2-cm safety margin around the tumor, based on clinical examination and anatomical-pathological frozen sections of the specimen. This procedure was always followed by perineal reconstruction with V-Y flaps by the plastic surgery team. Median follow-up was 12 months. The complication rate and lengths of hospital stay were evaluated and compared with those in a similar group in which radical vulvectomy was performed associated with two long longitudinal incisions in the groin. The data were statistically analyzed. The perineal and inguinal dehiscence rates in group A (traditional approach) were 68.4% and 78.94%, respectively. The same rates in group B (modified approach), were 10.5% and 36.84%, respectively. Mean hospital stay was 39.5 days in group A (traditional) vs. 14.0 days in group B (modified). At 30 months' median follow-up, the rate of local recurrence in group A (traditional) was 42.0%; at 12 months' median follow-up, local recurrence in group B (modified) was 26.3%. In this study, the use of V-Y flaps in combination with a modified oncological approach significantly reduced local complication rates and lengths of hospital stay, while observing oncological principles.
  International Journal of Gynecology & Obstetrics 06/1999; 65(2):157-63. · 2.05 Impact Factor
• Article: Pregnancy Following Breast Reconstruction with TRAM Flaps.

  F R Carramaschi, M L Ramos, J A Pinotti, M C Ferreira
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  ABSTRACT: From a retrospective study of 250 patients submitted to immediate breast reconstruction with TRAM flap after mastectomy for breast cancer, we reported the occurrence of pregnancy in seven cases from January 1992 to January 1996 at the Women's Health Reference Center and at the University of São Paulo Medical School. There were six immediate and one delayed reconstructions. Mean age was 35 years old. Outpatient follow-up was 13 months (mean 6-42 months). Two of the seven patients developed abdominal bulge, but no hernias were detected in this group. All patients were satisfied with the aesthetic result. Seven of them came to term. No abnormalities were found in their children. During the same period of time bulging was found in 10% of the 250 patients. Breast reconstruction with TRAM flap is safe even if patients become pregnant, and in this study TRAM flaps did not cause dyfunctional labor or significant abdominal wall damage.
  The Breast Journal 07/1998; 4(4):258-60. · 1.64 Impact Factor