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Introduction: Abdominoperineal resection after radiotherapy has a high rate of perineal wound complications. The aim of this retrospective study was to evaluate the results of perineal reconstruction with a rectus abdominis muscle myocutaneous flap in patients with recurrent or persistent anal cancer., Patients and Method: Between 2006 and 2010, six male HIV+ patients were treated after initial treatment failure with chemotherapy. An anterior rectal myocutaneous flap was performed after abdominal-perineal excision., Results: The mean age was 36.3 years (range: 30-42). Primary healing of the perineal wound was achieved in the first thirty days. There were no major complications in the immediate post-surgical period or after a mean follow up of 26.5 months. There were 2 (33.3%) minor complications associated with the perineal wound. There were no complications of the abdominal wall., Conclusion: The use of an anterior rectus abdominis myocutaneous flap in patients with recurrent or persistent anal cancer is associated with a low rate of perineal complications., (Copyright © 2010 AEC. Published by Elsevier Espana. All rights reserved.)