Perineal closure following extralevator abdominoperineal excision for cancer of the rectum

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
J BarrieD A Evans

Abstract

Extralevator abdominoperineal resection (ELAPE) may be complicated by perineal wound healing problems and herniation. We report a consecutive series of 38 such patients with selective use of a fasciocutaneous V-Y buttock advancement flap (BAF). Data were collected on a series of patients undergoing ELAPE for rectal malignancy between August 2011 and July 2017. Demographics, management and outcomes were recorded prospectively. Perineal wound problems were considered as 'major' if they required packing; otherwise, they were classed as 'minor'. Thirty-eight patients [eight female and 30 male; median age 63 (range: 35-89) years] underwent ELAPE. Thirty-seven had an adenocarcinoma of the rectum and one had a malignant melanoma. The median tumour height (from the anal verge) was 30 (range: 0-80) mm. Sixteen patients had a BAF. The median length of stay was 10 (range: 6-25) days. Primary perineal healing occurred in 18 (47%) patients. Major wound breakdown occurred in three (10%) patients and minor wound breakdown in 17 (45%). Two of the 16 patients having a BAF had major wound breakdown: one wound took 9 weeks to heal completely and the other took 9 months. Of the 22 patients who did not have a BAF, one had a major wound breakdown wh...Continue Reading

References

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May 10, 2011·Diseases of the Colon and Rectum·Henrik Kidmose ChristensenSøren Laurberg
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Nov 22, 2014·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A E SayersI A Hunter
Jun 21, 2016·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·H JonesUNKNOWN LOREC group

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