Perineal reconstruction following anorectal excision

2021 ◽  
pp. 1247-1258
Author(s):  
Alexandra Crick
Keyword(s):  
Free Flaps ◽  
Abdominoperineal Excision ◽  
Vaginal Wall ◽  
Skin Defect ◽  
Salvage Procedure ◽  
Posterior Vaginal Wall ◽  
Perineal Reconstruction ◽  
Pedicled Flaps ◽  
Perineal Skin ◽  
History Of

Anorectal abdominoperineal excision, either as a primary procedure for rectal cancer or as a salvage procedure for residual or recurrent anal cancer following chemoradiotherapy, creates a defect of the pelvic floor, pelvic dead space, and a perineal skin defect and may include a defect of the posterior vaginal wall. The ideal reconstruction should address all components of this defect and aims to achieve primary uncomplicated healing while preserving and restoring function. Pedicled flaps from the abdomen, gluteal and thigh regions, and occasionally free flaps are available for this purpose. There is increasing evidence that flap reconstruction improves perineal healing especially where there is a history of radiotherapy.

Rare case of perforated appendicitis presenting as persistent perineal discharge following laparoscopic abdominoperinal excision of rectum (APER)

2021 ◽  
Vol 14 (1) ◽  
pp. e236312
Author(s):  
Tanmoy Mukherjee ◽  
Shantata Jayant Kudchadkar ◽  
Jayesh Sagar ◽  
Shashank Gurjar
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Perforated Appendicitis ◽  
Perineal Wound ◽  
Abdominoperineal Excision ◽  
Major Surgery ◽  
Salvage Procedure ◽  
Uncommon Presentation ◽  
Rare Case Report ◽  
History Of

Abdominoperineal excision of rectum (APER) is one of the widely used surgical procedures to treat low rectal cancer, benign conditions like Crohn’s proctitis with anal involvement and as a salvage procedure for anal cancer. Perineal wound infection is a well-recognised complication following such major surgery. Occurrence of appendicitis in a few weeks’ time following such a major surgery is uncommon. However, here we present a rare case report of perforated appendicitis presenting as persistent perineal discharge in an elderly man, following laparoscopic APER for a low rectal tumour. To our knowledge, this is the first time such a rare clinical presentation of appendicitis is reported in the history of medical literature. Through this case report, we aim to highlight the importance of considering such an uncommon presentation in patients with perineal discharge, following APER.

scholarly journals Malignant Melanoma of the Vagina - A Case Report

1970 ◽  
Vol 26 (2) ◽  
pp. 103-105
Author(s):  
Nilufa Sultana ◽  
Chowdhury Md Ali ◽  
Rawshan Ara Khanam ◽  
Prof Mahmuda Khatan
Keyword(s):  
Case Report ◽  
Malignant Melanoma ◽  
Small Mass ◽  
Vaginal Wall ◽  
Excision Biopsy ◽  
Posterior Vaginal Wall ◽  
Urethral Meatus ◽  
Antitubercular Drugs ◽  
History Of ◽  
Post Menopausal

A 52 yrs old post menopausal lady was admitted in-the Gynae department of SSMC & Mitford Hospital with a small mass in the lower vagina, foul smelling discharge and occasional itching at that site for 1 year. Examination revealed a small, irregular, firm, partially necrosed, non tender growth with foul smelling brownish discharge 2cm below the external urethral meatus, uterus atrophied, cervix flashed, fornicesfree but few small, black, flat nodules scattered in the posterior vaginal wall. She had no history of exposure to any radiation or sunlight to that area or surgery but only received antitubercular drugs for six month for pulmonary tuberculosis. After conservative treatment excision biopsy was taken and histopathology revealed Malignant Melanoma. She was referred to cancer Institute for adjuvent radiotherapy. DOI: 10.3329/jbcps.v26i2.4190 J Bangladesh Coll Phys Surg 2008; 26:103-105

scholarly journals Pregnancy after tension-free vaginal mesh (anterior Prolift) and concomitant tension-free vaginal tape-obturator procedure

2011 ◽  
Vol 25 (1) ◽  
pp. 17
Author(s):  
Xiao Luo ◽  
Li Xiao Wan ◽  
Hong Shen ◽  
Yin Xiu Xia ◽  
Chao Han Zhang ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Young Patients ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Vaginal Mesh ◽  
Pelvic Floor Reconstruction ◽  
Tension Free ◽  
Tension Free Vaginal Tape ◽  
History Of ◽  
Vaginal Tape Obturator

<em>Objective</em>. Treatment of anterior vaginal wall prolapse and stress urinary incontinence (SUI) with transobturator tension-free vaginal mesh (anterior Prolift) and concomitant tension-free vaginal tape-obturator (TVT-O) has been proved feasible, safe and effective. However, there is little known about the influence of pregnancy on women who have had such procedures before pregnancy. <em>Design and methods.</em> A 32-year-old woman (gravid 1, para 1) with two years history of SUI and nine months history of pelvic organ prolapse (POP) was treated with transobturator tension-free vaginal mesh (anterior Prolift) and concomitant TVT-O. Her recovery was excellent, and she was pregnant eight months after the operation. <em>Results</em>. The patient went through her pregnancy smoothly with no special discomfort and successfully delivered an infant via caesarean section without recurrence of POP and SUI. Her last visit to our clinic about 14 months after caesarean section revealed that the anterior Prolift mesh and TVT-O mesh still remained intact and the position of the vaginal fornix, anterior and posterior walls and uterus also remained normal. <em>Conclusions</em>: Pelvic floor reconstruction with vaginal mesh (Prolift) may have positive significance for young patients who desire uterine preservation for future pregnancies. However, further studies are warranted to determine whether it can be used in pregnant women or women planning future pregnancies.

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