Discussion: System-Level Determinants of Access to Flap Reconstruction after Abdominoperineal Resection

Kapur, Sahil K.; Butler, Charles E.

doi:10.1097/prs.0000000000008664

Cited by 1 publication

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References 11 publications

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“…27,29 In a population-based study of patients with commercial insurance, Billig et al demonstrated that patients who underwent flap reconstruction following abdominoperineal resection have more “healthy days” without incurring more expenses. 27–30 In addition, there were no differences in effective cost and complications at 6 months postoperatively between perineal defects that were primarily closed versus flap reconstruction, further emphasizing the superior clinical outcomes and cost-effectiveness of this method. However, only a small percentage of abdominoperineal resection patients undergo flap reconstruction, highlighting the profound gap that exists between patients that actually undergo flap reconstruction compared to patients that would benefit from this reconstructive surgery.…”

Section: Discussionmentioning

confidence: 90%

System-Level Determinants of Access to Flap Reconstruction after Abdominoperineal Resection

Dayani¹,

Sheckter²,

Rochlin³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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reatment of low-lying anorectal cancer and pelvic malignancies often involves neoadjuvant chemoradiation followed by abdominoperineal resection or pelvic exenteration. The resulting large soft-tissue defect can undergo primary closure or flap reconstruction. Even though the superiority of each method with regard to wound healing complications remains controversial in the literature, most studies demonstrate that attempts at primary closure following abdominoperineal resection are associated with high morbidity and complication rates. [1][2][3][4][5][6][7][8][9][10][11][12][13] Immediate flap reconstruction following abdominoperineal resection reduces the incidence of wound healing complications and fills dead-space created by tumor extirpation. 1,[4][5][6][7][8][9][10]12 More specifically, immediate flap reconstruction has been associated with lower rates of local

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Section: Discussionmentioning

confidence: 90%