Meta-analysis of biological mesh reconstruction versus primary perineal closure after abdominoperineal excision of rectal cancer

Ahmad, Nasir Zaheer; Abbas, Muhammad Hasan; Al-Naimi, Noof; Parvaiz, Amjad

doi:10.1007/s00384-020-03827-0

Cited by 7 publications

(2 citation statements)

References 51 publications

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“…In addition, it may further decrease the local recurrence rate and improve survival (18). Biological mesh was applied to reduce perineal hernia, perineal wound complications and post-operative radiation pelvic disease (19).…”

Section: Discussionmentioning

confidence: 99%

Fournier's gangrene due to rectal cancer: A case report

Hou,

Cheng,

Shen

et al. 2024

Mol Clin Oncol

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Fournier's gangrene (FG) is an extremely rare necrotizing fasciitis that is insidious, rapidly spreading and life-threatening. FGs due to rectal cancer occur rarely and there is a lack of clinical reference. In the present study, a severe FG due to rectal cancer perforation was described and the features of this rare disease were summarized with a literature review. A 57-year-old man was admitted because of rectal cancer-induced FG. The patient was misdiagnosed with extensive perianal abscess until the intraoperative biopsy confirmed that rectal cancer was the culprit. Incision, debridement and drainage were carried out to reduce infectious burdens. After that, the patient was transferred to Peking University People's Hospital for the subsequent therapy. Empirical broad-spectrum antibiotic therapy was used at the initial stage. Diversional transverse loop colostomy was performed to control infection and resume oral feeding. After four rounds of vacuum-assisted closure (VAC) therapy, radical resection and wound closure were accomplished. The scrotal defect was repaired by a skin flap. Pathological results indicated a moderately differentiated adenocarcinoma with perforation. The patient was discharged from the hospital on postoperative day 15 without any post-operative complications. No signs of recurrence were observed during a 22-month follow-up. In the setting of rectal cancer-induced FGs, the liquid resuscitation, broad-spectrum antibiotic therapy, and prompt debridement are the cornerstones of the initial management. Diversional colostomy and VAC therapy were effective in the management of severe infection and large wounds. The present case report also provided a clinical reference for the implementation of staged surgeries and the perioperative multidisciplinary management of FGs.

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Section: Discussionmentioning

confidence: 99%

Fournier's gangrene due to rectal cancer: A case report

Hou,

Cheng,

Shen

et al. 2024

Mol Clin Oncol

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show abstract

“…After 1 year, the incidence of perineal hernia was significantly high after primary closure of the perineal wounds (odds ratio, 0.400; 95% CI, 0.240–0.665; P = 0.001). Both studies found that the perineal hernia rate was significantly lower in biologic mesh reconstruction as compared to primary closure and the operation time and hospital stay were shorter after primary perineal closure [ 125 , 126 ]. Other studies have shown a lower incidence of surgical site infection using prophylactic negative-pressure wound therapy to prevent wound-related complications in surgery, with a risk reduction of about 25% to 30% [ 127 ].…”

Section: Surgical Managementmentioning

confidence: 99%

Surgical Treatment of Low-Lying Rectal Cancer: Updates

Varela

Kim

2021

Ann Coloproctol

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Despite innovative advancements, distally located rectal cancer remains a critical disease of challenging management. The crucial location of the tumor predisposes it to a circumferential resection margin (CRM) that tends to involve the anal sphincter complex and surrounding organs, with a high incidence of delayed anastomotic complications and the risk of the pelvic sidewall or rarely inguinal lymph node metastases. In this regard, colorectal surgeons should be aware of other issues beyond total mesorectal excision (TME) performance. For decades, the concept of extralevator abdominoperineal resection to avoid compromised CRM has been introduced. However, the complexity of deep pelvic dissection with poor visualization in low-lying rectal cancer has led to transanal TME. In contrast, neoadjuvant chemoradiotherapy (NCRT) has allowed for the execution of more sphincter-saving procedures without oncologic compromise. Significant tumor regression after NCRT and complete pathologic response also permit applying the watch-and-wait protocol in some cases, now with more solid evidence. This review article will introduce the current surgical treatment options, their indication and technical details, and recent oncologic and functional outcomes. Lastly, the novel characteristics of distal rectal cancer, such as pelvic sidewall and inguinal lymph node metastases, will be discussed along with its tailored and individualized treatment approach.

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Management of the Unhealed Perineal Wound After Proctectomy

Poylin,

Abbass

2023

Difficult Decisions in Surgery: An Evidence-Based Approach

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Meta-analysis of biological mesh reconstruction versus primary perineal closure after abdominoperineal excision of rectal cancer

Cited by 7 publications

References 51 publications

Fournier's gangrene due to rectal cancer: A case report

Fournier's gangrene due to rectal cancer: A case report

Surgical Treatment of Low-Lying Rectal Cancer: Updates

Management of the Unhealed Perineal Wound After Proctectomy

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