The pedicled Antero lateral thigh flap for gender affirming surgery: what is different? First case series outcomes of a single center from Turkey

Colgajo anterolateral del muslo regional para cirugía genital transgénero. ¿Qué tiene de diferente? Primer reporte de serie de casos en un centro hospitalario de Turquía

The aim of this study is to share our preliminary outcomes of the pedicled Antero Lateral Thigh flap (ALTf) phalloplasty technique, which we presume to be the first reported case series of a single center from Turkey. A cross-sectional study, comprising all cases who underwent pedicled ALTf phalloplasty in our clinic, between January 2015 and December 2019, was designed. Demographic data, case characteristics and surgical details including complications were recorded. The mean age of our 26 cases was 30 (28–34) years. The mean penile length and diameter were 15.07 ± 0.98 cm and 3.9 ± 0.34 cm, respectively. Tactile sensation was evaluated by touching the radix, corpus and tip of the neo-phallus showing response in 17 (65.4%), 7 (26.9%) and 2 (7.7%) of the cases, respectively. In 14 (53.8%) of all our cases no complication was reported at all. However, in 12 (46.1%) cases, although no intraoperative complication occurred; postoperative complications were observed as Clavien-2 (3.8%), Clavien-3a (3.8%) and Clavien-3b (71%). Postoperative satisfaction rates were found 77.14% (38–94). Although relevant studies are limited, in addition to low complication rates and high satisfactory outcomes, by leading to a concealable donor site, the pedicled ALTf can be used as a preferred phalloplasty technique, especially in transmen with religious or cultural sensibility.

Resumen

El objetivo de este estudio es compartir los problemas preliminares de la técnica de faloplastia pediculada con colgajo anterolateral de muslo (ALTf), que creemos que es la primera serie de casos de un solo centro en Turquía. Se diseñó un estudio transversal de todos los casos intervenidos de faloplastia con colgajo anterolateral del muslo regional (ALTF) de nuestro hospital entre Febrero de 2015 hasta Diciembre de 2019. Se registraron los datos demográficos, las características de los casos y los detalles quirúrgicos, incluyendo también las complicaciones. La edad media de nuestros 26 casos fue de 30 (28–34) años. La longitud y el diámetro medios del pene fueron de 15.07 ± 0.98 cm y 3.0 ± 0.34 cm, respectivamente. La sensación táctil se evaluó tocando la raíz, el cuerpo y la punta del neofalo mostrando respuesta en 17 (65.4%), 7 (26.9%) y 2 (7.7%) de los casos respectivamente. En 14 (53.8%) de todos nuestros casos no se reportó ninguna complicación. Sin embargo en 12 casos (46.1%) aunque no se presentó ninguna complicación transoperatoria; las complicaciones postoperatorias se presentaron Clavien-2 (3.8%), Clavien-3a (3.8%), Clavien 3b (71%). Se documentaron índices de satisfacción postoperatoria en el 77.14% (38–94). Además de la baja tasa de complicaciones y los resultados altamente satisfactorios, al ser un sitio anatómico oculto, el colgajo anterolateral del muslo regional (ALTF), se puede utilizar como técnica preferida de faloplastía, especialmente en hombres transgénero con presión religiosa o cultural.

Anterolateral thigh flap; Gender incongruence; Pedicled flap; Phalloplasty; Reconstruction; Transgender surgery

Palabras Clave

Colgajo anterolateral del muslo regional; Incongruencia de género; Colgajo pediculado; Faloplastía; Reconstrucción; Cirugía transgénero

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