旨在评估根治性切除术后使用 V-Y 重建皮瓣是否对外阴癌患者的手术结果产生积极影响。这是一项多中心、回顾性、对照研究。比较接受根治性手术和外阴重建以及接受根治性手术但不进行重建步骤的浸润性外阴癌女性的手术结果和并发症发生率。仅接受双侧或单侧 V-Y 推进筋膜皮瓣的患者被纳入重建组。使用单变量和多变量 Logistic 回归模型分析预测变量与并发症发生率的关系。总共纳入了 361 名患者：190 名 (52%) 名患者在切除根治性手术后接受了重建步骤，并与 171 名 (47.4%) 名患者进行了比较。没有经历重建步骤。在多变量分析中，体重指数>30kg/m2（优势比（OR）3.36，p=0.007）和糖尿病（OR 2.62，p<0.022）与伤口感染独立相关。此外，年龄增加（OR 1.52，p=0.009）、体重指数>30 kg/m2（OR 3.21，p=0.002）和国际妇产科联合会（FIGO）III-IV期（OR 2.25，p= 0.017）是伤口裂开的独立预测因子。事实证明，接受 V-Y 重建皮瓣的患者术后伤口并发症的发生率显着降低。这在病变 > 4 cm 的女性中相关性更显着。在外阴手术中采用 V-Y 皮瓣与减少手术相关并发症相关，特别是在切除根治性手术后涉及大手术缺陷的脆弱患者中。© IGCS 和 ESGO 2024。无商业广告重复使用。请参阅权利和权限。英国医学杂志出版。

To assess if the use of a V-Y reconstructive flap after excisional radical surgery positively influences the surgical outcomes in patients with vulvar cancer.This was a multicenter, retrospective, controlled study. Surgical outcomes and complication rates of women with invasive vulvar cancer who underwent radical surgery and vulvar reconstruction and those who underwent radical surgery without the reconstruction step were compared. Only patients who underwent bilateral or unilateral V-Y advancement fascio-cutaneous flaps were included in the reconstruction group. Univariate and multivariate logistic regression models were used to analyze predicting variables for their association with complication rates.Overall, 361 patients were included: 190 (52%) underwent the reconstructive step after the excisional radical procedure and were compared with 171 (47.4%) who did not undergo the reconstructive step. At multivariate analysis, body mass index >30 kg/m2 (odds ratio (OR) 3.36, p=0.007) and diabetes (OR 2.62, p<0.022) were independently correlated with wound infection. Moreover, increasing age (OR 1.52, p=0.009), body mass index >30 kg/m2 (OR 3.21, p=0.002,) and International Federation of Gynecology and Obstetrics (FIGO) stages III-IV (OR 2.25, p=0.017) were independent predictors of wound dehiscence. A significant reduction in the incidence of postoperative wound complications among patients who underwent V-Y reconstructive flaps was demonstrated. This was correlated more significantly in women with lesions >4 cm.The adoption of V-Y flaps in vulvar surgery was correlated with reduced surgical related complications, particularly in vulnerable patients involving large surgical defects following excisional radical procedures.© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.