Abstract: 【Abstract】 Objective To investigate the clinical efficacy of bilateral V-Y advancement island flaps on buttocks in repairing postoperative defects in patients with perianal Paget′s disease. Methods From January 2009 to January 2021, a retrospective analysis was performed on clinical data collected from 13 patients with perianal Paget′s disease in the Department of Dermatology, Hangzhou Third People′s Hospital, whose perianal defects resulting from the tumor resection were reconstructed with bilateral V-Y advancement island flaps on the buttocks. The postoperative recovery condition of the buttocks and the effects on the anal defecation function were evaluated. Results The area of perianal defects in 13 cases ranged from 4.8 cm × 5.6 cm to 12.2 cm × 6.4 cm. All defects were successfully repaired by using the bilateral V-Y advancement island flaps, and all surgical wounds healed primarily. One case first received temporary ileostomy, and then received ileostomy restoration surgery 3 months later, resulting in the recovery of defecation function; in another 1 case of perianal Paget′s disease comorbid with rectal cancer, the permanent sigmoid colostomy was performed to divert feces, and the defecation function was lost. After the follow-up of 1 - 6 years, symmetrical shapes of the buttocks were obtained in all the 13 patients, and 12 with preserved anus had normal defecation function. No tumor recurrence was observed in 12 patients without other malignant tumors after the operation, while mild anal stenosis without anal mucosa eversion or wound dehiscence occurred in 3; 1 patient with perianal Paget′s disease complicated by anal canal adenocarcinoma developed bilateral inguinal lymph node and internal iliac lymph node metastasis 1 year after the operation, and died 6 months later. Conclusion The bilateral V-Y advancement island flaps on the buttocks have the advantage of reliable blood supply and sufficient advancement mobility, and can repair large skin defects around the anus.

Key words: Paget disease, extramammary, Perianal defect, Island flap, V-Y advancement, Repair