Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer

The British Journal of Surgery
T HolmJ Lagergren

Abstract

Intraoperative tumour perforation, positive tumour margins, wound complications and local recurrence are frequent difficulties with conventional abdominoperineal resection (APR) for rectal cancer. An alternative technique is the extended posterior perineal approach with gluteus maximus flap reconstruction of the pelvic floor. The aim of this study was to report the technique and early experience of extended APR in a select cohort of patients. The principles of operation are that the mesorectum is not dissected off the levator muscles, the perineal dissection is done in the prone position and the levator muscles are resected en bloc with the anus and lower rectum. The perineal defect is reconstructed with a gluteus maximus flap. Between 2001 and 2005, 28 patients with low rectal cancer were treated accordingly at the Karolinska Hospital. Two patients had ypT0 tumours, 20 ypT3 and six ypT4 tumours. Bowel perforation occurred in one, the circumferential resection margin (CRM) was positive in two, and four patients had local perineal wound complications. Two patients developed local recurrence after a median follow-up of 16 months. The extended posterior perineal approach with gluteus maximus flap reconstruction in APR has a low ri...Continue Reading

References

May 1, 1992·World Journal of Surgery·D A Rothenberger, W D Wong
Jun 1, 1988·International Journal of Colorectal Disease·P Quirke, M F Dixon
Jul 1, 1986·Journal of Surgical Oncology·N PetrelliA Mittelman
Mar 1, 1996·The British Journal of Surgery·G ArbmanR Sjödahl
Jul 1, 1997·Diseases of the Colon and Rectum·R J HealdB J Moran
Aug 26, 1998·Archives of Surgery·R J HealdJ K MacFarlane
Jun 14, 2000·Plastic and Reconstructive Surgery·W K MilesG L Robb
Feb 23, 2002·The American Journal of Surgical Pathology·Iris D NagtegaalUNKNOWN Cooperative Clinical Investigators
Dec 17, 2003·Annals of Plastic Surgery·Edward Wayne BuchelCraig Johnson
Jan 14, 2004·Diseases of the Colon and Rectum·Arne WibeUNKNOWN Norwegian Rectal Cancer Group
Feb 5, 2004·The British Journal of Surgery·M T EriksenUNKNOWN Norwegian Gastrointestinal Cancer Group
Dec 8, 2004·The British Journal of Surgery·A WibeUNKNOWN Norwegian Rectal Cancer Group
Dec 21, 2004·The British Journal of Surgery·A MartlingB Cedermark
Feb 5, 2005·Diseases of the Colon and Rectum·Caprice K ChristianRonald Bleday
May 4, 2005·Recent Results in Cancer Research. Fortschritte Der Krebsforschung. Progrès Dans Les Recherches Sur Le Cancer·G Brown, I R Daniels
Jun 4, 2005·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·P P TekkisUNKNOWN Association of Coloproctology of Great Britain and Ireland
Oct 14, 2005·World Journal of Surgery·Floris T J FerenschildJohannes H W de Wilt
Dec 20, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Iris D NagtegaalUNKNOWN Pathology Review Committee
Feb 10, 2006·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A Radcliffe

❮ Previous
Next ❯

Citations

Sep 24, 2008·European Radiology·Oliver C ShihabGina Brown
Aug 9, 2008·International Journal of Colorectal Disease·Nicola PetrieHelen Chave
Nov 7, 2008·International Journal of Colorectal Disease·Peer Wille-JørgensenPeter Møller
Mar 30, 2010·International Journal of Colorectal Disease·Fredrik JörgrenGudrun Lindmark
Jun 16, 2010·International Journal of Colorectal Disease·Sigmar StelznerHelmut Witzigmann
Feb 26, 2011·International Journal of Colorectal Disease·Sigmar StelznerHelmut Witzigmann
May 24, 2011·International Journal of Colorectal Disease·Sigmar StelznerHelmut Witzigmann
Nov 1, 2011·International Journal of Colorectal Disease·Ilmo KellokumpuKyösti Nuorva
Oct 19, 2011·International Journal of Colorectal Disease·Oliver PeacockJ N Lund
Mar 28, 2012·International Journal of Colorectal Disease·E AngeneteE Haglind
Feb 27, 2013·International Journal of Colorectal Disease·Hisham Z ButtBaljit Singh
Jun 28, 2011·Surgical Endoscopy·R SiegelUNKNOWN European Association for Endoscopic Surgery (EAES)
Nov 19, 2013·Hernia : the Journal of Hernias and Abdominal Wall Surgery·E Chelala, S Declercq
Jul 18, 2009·Techniques in Coloproctology·Duncan StewartA Shorthouse
Oct 26, 2010·Journal of Gastrointestinal Cancer·Mark A BoccolaMatthew A Croxford
May 15, 2010·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·Carmen FausSamuel Navarro
Jun 26, 2009·Journal de chirurgie·K SlimP Valleur
Dec 5, 2009·The Lancet Oncology·Oliver C ShihabBrendan J Moran
Jun 6, 2009·Nature Reviews. Gastroenterology & Hepatology·Vincenzo Valentini, Francesco Cellini
Jun 29, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B GlimeliusUNKNOWN ESMO Guidelines Working Group
Oct 23, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B GlimeliusUNKNOWN ESMO Guidelines Working Group
Oct 30, 2013·Plastic and Reconstructive Surgery·Damien G GrinsellPatrick D T Tansley
Dec 17, 2008·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M DaviesJ Beynon
Jul 22, 2008·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·H YoussefP Baragwanath
Jul 22, 2008·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·D Di MauroR Hierner
Dec 6, 2008·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·P J Nisar, H J Scott
Jun 13, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·W ChambersC Cunningham
Oct 30, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·P HermanekC Rödel
Jan 1, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M B NielsenT Holm
Oct 21, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S BülowUNKNOWN Danish Colorectal Cancer Group
Feb 2, 2011·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A G Renehan, S T O'Dwyer
Jun 10, 2011·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Ian Lindsey
Oct 11, 2011·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·C AnderinT Holm
Nov 10, 2011·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M T JefferiesU Khot
Jan 10, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·D AsplundE Angenete
Feb 9, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M MjoliP J Tanis
Sep 13, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·T J Moore, B J Moran
Jul 5, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A KrishnaP H Chapuis
Jul 6, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J D FosterN Francis
Jul 11, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A HiranyakasM Berho
Jul 14, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·O C ShihabB J Moran
Sep 13, 2012·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Paul Finan, Najib Haboubi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cancer Incidence & Mortality

Cancer has emerged as a global concern due to its increase in incidence and mortality. Efforts are underway to evaluate and develop action plans to reduce the global burden of cancer. Currently, lung cancer, breast cancer and prostate cancer are the leading causes of cancer mortality. Here is the latest research on cancer incidence and mortality.

Related Papers

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Nicholas P WestP Quirke
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Iris D NagtegaalPathology Review Committee
Diseases of the Colon and Rectum
Henrik Kidmose ChristensenSøren Laurberg
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Iris D Nagtegaal, Phil Quirke
© 2022 Meta ULC. All rights reserved