CHOICE OF THE METHOD OF CLOSING THE PELVIC FLOOR DEFECT AFTER EXTRALEVATOR ABDOMINAL-PERINEAL EXTIRPATION OF THE RECTUM (PRACTICAL RECOMMENDATIONS)

2017 ◽  
Vol 63 (2) ◽  
pp. 240-246
Author(s):  
Aleksey Belyaev ◽  
Andrey Domanskiy ◽  
Aleksey Karachun ◽  
Konstantin Lebedev ◽  
Denis Samsonov ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Wound Repair ◽  
Primary Closure ◽  
Perineal Wound ◽  
Flap Reconstruction ◽  
Muscular Flap ◽  
Mesh Reconstruction ◽  
Pelvic Floor Defect ◽  
Practical Recommendations

Extralevator abdominal-perineal extirpation of the rectum causes a vast perineal wound, which requires to be closed. The article considers different approaches to perineal wound repair including primary closure, mesh reconstruction and muscular flap reconstruction.

Rectus Flap Reconstruction Decreases Perineal Wound Complications After Pelvic Chemoradiation and Surgery: A Cohort Study

2005 ◽  
Vol 12 (2) ◽  
pp. 104-110 ◽  
Author(s):  
David B. Chessin ◽  
John Hartley ◽  
Alfred M. Cohen ◽  
Madhu Mazumdar ◽  
Peter Cordeiro ◽  
...  
Keyword(s):  
Cohort Study ◽  
Perineal Wound ◽  
Wound Complications ◽  
Flap Reconstruction ◽  
Perineal Wound Complications

scholarly journals The results of use of myoplasty for closure of the pelvic floor defect after extralevator abdominoperineal excision of the rectum

2019 ◽  
Vol 17 (6) ◽  
pp. 35-40
Author(s):  
N. A. Domansky ◽  
V. V. Semiglazov ◽  
A. M. Karachun ◽  
K. K. Lebedev ◽  
D. V. Samsonov ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Perineal Wound ◽  
Abdominoperineal Excision ◽  
Early Postoperative Period ◽  
Wound Complications ◽  
Pelvic Floor Reconstruction ◽  
Group Iii ◽  
Group I ◽  
Perineal Wound Complications ◽  
Group Ii

Background. Extralevator abdominoperineal excision is associated with a high incidence of perineal wound complications. There is no uniform standard for choosing the method for pelvic floor reconstruction after extralevator abdominoperineal excision.The purpose of the study was to compare the results of extralevator abdominoperineal excisions of the rectum using various methods of perineal wound closure.Materials and Methods. Between 2014 and 2018, 120 patients underwent extralevator abdominoperineal excisions of the rectum using various options for closure of the pelvic floor. The patients were divided into 3 groups. Group I patients (n=64) underwent simple plasty of the peritoneal wound. Group II patients (n=43) underwent myoplasty using the gluteus maximus muscle. Group III patients (n=13) underwent myoplasty using the rectus abdominis muscle. The incidence of perineal wound complications in the early postoperative period was assessed.Results. The total number of perineal wound complications in Group I, II and III was 33 (51.5 %), 13 (30.2 %), and 6 (46.1 %), respectively. Grade IIIA-IIIB complications according to the Clavien-Dindo classification were observed in 25 % of Group I patients, in 18.6 % of Group II patients and in 7.7 % of Group II patients. Postoperative perineal wound complications occurred more often in Group I patients after simple plasty than in Group II and III patients after myoplasty (51.5 % versus 30.2 %). However, perineal wound complications were observed more often in Group III than in Group II (46.1 % versus 30.2 %, respectively). No significant differences in the frequency of complications between 3 groups were found.Conclusion. Using various options for closure of the pelvic floor after extralevator abdominoperineal excisions of the rectum, there was a tendency to reduction in the incidence of grade IIIA-IIIB perineal wound complications.

Time to Chemotherapy After Abdominoperineal Resection: Comparison Between Primary Closure and Perineal Flap Reconstruction

2015 ◽  
Vol 40 (1) ◽  
pp. 225-230 ◽  
Author(s):  
Azah A. Althumairi ◽  
Joseph K. Canner ◽  
Nita Ahuja ◽  
Justin M. Sacks ◽  
Bashar Safar ◽  
...  
Keyword(s):  
Abdominoperineal Resection ◽  
Primary Closure ◽  
Flap Reconstruction

Recent Experience with Abdominal Perineal Resection with Vertical Rectus Abdominis Myocutaneous Flap Reconstruction after Preoperative Pelvic Radiation

2009 ◽  
Vol 75 (10) ◽  
pp. 995-999 ◽  
Author(s):  
Marcelo W. Hinojosa ◽  
Dhavan A. Parikh ◽  
Raman Menon ◽  
Garrett A. Wirth ◽  
Michael J. Stamos ◽  
...  
Keyword(s):  
Myocutaneous Flap ◽  
Perineal Wound ◽  
Rectus Abdominis ◽  
Wound Complications ◽  
Recent Experience ◽  
Flap Reconstruction ◽  
Pelvic Radiation ◽  
Rectus Abdominis Myocutaneous Flap ◽  
Perineal Wound Complications ◽  
Vertical Rectus Abdominis Myocutaneous

Abdominoperineal resection (APR) after pelvic radiation can be complicated by an increased rate of difficult to treat perineal wound complications. In an effort to improve postoperative morbidity after APR, myocutaneous flap reconstructions have been used. We review our recent experience with APR with vertical rectus abdominis myocutaneous flap reconstruction (VRAM) after preoperative pelvic radiation. A retrospective review of patients who underwent APR with VRAM reconstruction after pelvic radiation from December 2004 to July 2008 was conducted. Outcome measures included demographics, comorbidities, length of stay, wound complications, and morbidity and mortality. Fifteen patients with a mean age of 61 ± 9 years underwent APR with VRAM reconstruction. Five patients also required posterior vaginectomy with the APR. Indications for APR were rectal cancer (n = 14, 93%) and anal canal cancer (n = 1, 7%). There were no intraoperative complications. Mean estimated blood loss was 635 ± 446 mL and mean intraoperative blood transfusion requirements were 1 ± 2 units. Mean length of hospital stay was 11 ± 4 days. Six (40%) patients had minor perineal wound complications. One (7%) patient had a perineal wound infection requiring reoperation with washout and reapproximation. There was no 30-day or in-hospital mortality. All VRAM flaps remained viable through follow-up. APR with VRAM flap reconstruction after preoperative pelvic radiation can be performed safely with limited wound complications and no mortality.

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