Gluteus maximus adipomuscular turnover or sliding flap in the surgical treatment of extensive sacral chordomas

Sacral chordoma is a low-grade malignant tumor often discovered in a late s tage, many times reaching a considerable size before presenting for surgica l treatment.(1,2) In such a case, a high sacral amputation would be require d and coverage of the resultant large defect at the posterior peritoneum be comes a difficult problem.(3) Dead spaces at the posterior peritoneum easil y develop serious postoperative complications such as infection, fistula fo rmation, and bowel obstruction. In this article, we present the gluteus max imus adipomuscular turnover or sliding flap as a modification of the conven tional gluteus maximus muscle flap for immediate reconstruction of the exte nsive posterior peritoneal defect after resection of sacral chordomas.