Endoscopically assisted extralevator abdominoperineal excision

Buchs, Nicolas; Kraus, Rebecca; Mortensen, N. J. McC.; Cunningham, Chris; George, Bruce; Jones, Oliver; Guy, Richard; Ashraf, Shazad; Lindsey, Ian; Hompes, Roel

doi:10.1111/codi.13144

Cited by 16 publications

(13 citation statements)

References 11 publications

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“…The combination of neoadjuvant chemoradiotherapy and ELAPE almost doubles the rate of perineal wound complications (31% for ELAPE vs 18% for cAPR)[5]. While new techniques and approaches have attempted to reduce the size of the perineal incision (and therefore reduce the risk of wound complications)[6], optimal management of perineal defects is still under investigation. The options include primary closure, myocutaneous flaps, and mesh reconstruction, including the use of a biological mesh.…”

Section: Introductionmentioning

confidence: 99%

Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review

Schiltz¹,

Buchs²,

Penna³

et al. 2017

WJCO

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Extralevator abdominoperineal excision and pelvic exenteration are mutilating operations that leave wide perineal wounds. Such large wounds are prone to infection and perineal herniation, and their closure is a major concern to most surgeons. Different approaches to the perineal repair exist, varying from primary or mesh closure to myocutaneous flaps. Each technique has its own associated advantages and potential complications and the ideal approach is still debated. In the present study, we reviewed the current literature and our own local data regarding the use of biological mesh for perineal wound closure. Current evidence suggests that the use of biological mesh carries an acceptable risk of wound complications compared to primary closure and is similar to flap reconstruction. In addition, the rate of perineal hernia is lower in early follow-up, while long-term hernia occurrence appears to be similar between the different techniques. Finally, it is an easy and quick reconstruction method. Although more expensive than primary closure, the cost associated with the use of a biological mesh is at least equal, if not less, than flap reconstruction.

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Section: Introductionmentioning

confidence: 99%

Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review

Schiltz¹,

Buchs²,

Penna³

et al. 2017

WJCO

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“…Twenty patients underwent a transanal rectal resection including taTME (16), endoscopic ELAPE (2) and completion proctectomy (2). Patient characteristics are shown in Table 1.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Transanal rectal resection: an initial experience of 20 cases

et al. 2016

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“…A 65-year-old woman underwent a laparoscopic abdominoperineal excision of a low rectal tumour with transanal endoscopic assistance [2]. Anaesthesia was commenced with spinal injection of 2.5 mL 0.5% heavy bupivacaine and 0.3 mg diamorphine, followed by general anaesthesia.…”

Section: Dear Editormentioning

confidence: 99%