Impact of perineal pseudocontinent colostomy on perineal wound healing after abdominoperineal resection

Dumont, Frédéric; Souadka, Amine; Goèré, Diane; Lasser, P; Élias, Dominique

doi:10.1002/jso.22105

Cited by 12 publications

(16 citation statements)

References 30 publications

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“…In subgroup analysis of APR with primary perineal closure for nonlocally advanced disease, the association of OP with 30-day wound complications remained nonsignificant (RR 1.28; 95% CI 0.64-2.56; I 2 ¼ 73%). 2,4,24 There was no reduced risk of pelviperineal morbidity within 1 year (RR 1.18; 95% CI 0.80-1.74; I 2 ¼ 80%) 2,4,22,24,28 or within the total study period (RR 1.09; 95% CI 0.83-1.44; I 2 ¼ 69%) 2,4,9,10,[22][23][24]28,30 for patients submitted to OP.…”

Section: Perineal Wound Healingmentioning

confidence: 97%

“…After deduplication, the combined search yielded 1081 articles, of which 26 were identified as potentially eligible. After contacting the authors, individual patient data were provided in six [4][5][6][22][23][24] and aggregate data in four. [25][26][27][28] An additional of 4 studies with full text of the original paper only were included.…”

Section: Literature Search and Selectionmentioning

confidence: 99%

“…Twelve studies recorded the incidence of presacral abscess formation. [4][5][6]10,[22][23][24][25][26][27][28][29] The overall weighted mean proportion of presacral abscess formation following OP was 8.7% (95% CI 6.1%-12.3%). Considering 9 comparative studies, 4 -6,10,22-24,26,28 presacral abscesses similarly occurred after OP and non-OP (RR 1.11; 95% CI 0.79-1.56; I 2 ¼ 0%) ( Fig.…”

Section: Presacral Abscessmentioning

confidence: 99%

“…4 -6,23,24 Similarly, there was no reduced risk of developing presacral abscesses after OP when only analyzing the patients who have been treated with preoperative radiotherapy (RR 0.94; 95% CI 0.61-1.45; I 2 ¼ 0%). 2,4,6,23,24…”

Section: Presacral Abscessmentioning

confidence: 99%

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A Systematic Review and Meta-analysis on Omentoplasty for the Management of Abdominoperineal Defects in Patients Treated for Cancer

Blok

Hagemans²,

Klaver

et al. 2020

Annals of Surgery

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The objective of this systematic review and meta-analysis was to examine the effects of omentoplasty on pelviperineal morbidity following abdominoperineal resection (APR) in patients with cancer. Background: Recent studies have questioned the use of omentoplasty for the prevention of perineal wound complications. Methods: A systematic review of published literature since 2000 on the use of omentoplasty during APR for cancer was undertaken. The authors were requested to share their source patient data. Meta-analyses were conducted using a random-effects model. Results: Fourteen studies comprising 1894 patients (n ¼ 839 omentoplasty) were included. The majority had APR for rectal cancer (87%). Omentoplasty was not significantly associated with the risk of presacral abscess formation in the overall population (RR 1.11; 95% CI 0.79-1.56), nor in planned subgroup analysis (n ¼ 758) of APR with primary perineal closure for nonlocally advanced rectal cancer (RR 1.06; 95% CI 0.68-1.64). No overall differences were found for complicated perineal wound healing within 30 days (RR 1.30; 95% CI 0.92-1.82), chronic perineal sinus (RR 1.08; 95% CI 0.53-2.20), and pelviperineal complication necessitating reoperation (RR 1.06; 95% CI 0.80-1.42) as well. An increased risk of developing a perineal hernia was found for patients submitted to omentoplasty (RR 1.85; 95% CI 1.26-2.72). Complications related to the omentoplasty were reported in 4.6% (95% CI 2.5%-8.6%). Conclusions: This meta-analysis revealed no beneficial effect of omentoplasty on presacral abscess formation and perineal wound healing after APR, while it increases the likelihood of developing a perineal hernia. These findings do not support the routine use of omentoplasty in APR for cancer.

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Section: Perineal Wound Healingmentioning

confidence: 97%

Section: Literature Search and Selectionmentioning

confidence: 99%

Section: Presacral Abscessmentioning

confidence: 99%

Section: Presacral Abscessmentioning

confidence: 99%

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A Systematic Review and Meta-analysis on Omentoplasty for the Management of Abdominoperineal Defects in Patients Treated for Cancer

Blok

Hagemans²,

Klaver

et al. 2020

Annals of Surgery

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“…26 extended resection to other pelvic organs is necessary to ensure complete oncological resection in locally advanced cancer. in our experience, we think that the use of perineal drainage by simple or corrugated drain in the posterior side of the scar can help to prevent these complications.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Poor Functional Results at 1-Year After Pseudocontinent Perineal Colostomy for Ultralow Rectal Adenocarcinoma

Souadka¹,

Majbar²,

Bougutab³

et al. 2013

Diseases of the Colon &Amp; Rectum

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Functional outcomes over time following perineal pseudocontinent colostomy reconstruction after abdominoperineal resection for ultralow rectal adenocarcinoma

Souadka

Majbar

Essangri

et al. 2020

Journal of Surgical Oncology

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Background and ObjectivesPseudocontinent‐perineal colostomy (PCPC) following abdominoperineal resection (APR) is a promising technique associated with good quality of life. This study evaluates over time the functional results after PCPC using the Kirwan score.MethodsAll PCPC patients operated on from January 2001 to January 2016 were followed with their functional results assessed at four checkpoints. A/B Kirwan scores and a 48 to 72 hours colonic irrigation rhythm were considered “good” and “convenient” and their overall variations over time were assessed by means of Cochran's Q test corrected by Bonferroni post hoc test.ResultsFifty‐seven eligible patients were included in the study with 33 (58%) women. We noted a significant difference in both Kirwan score and colic irrigation rhythm during the four checkpoints in follow‐up with Q(1) = 85.01 and Q(2) = 69. 86. By the fourth checkpoint, 86% of patients had a Kirwan score of A/B. Concerning the rhythm of colonic irrigation, there was a significant improvement between 6 months and other checkpoints. In the second year, 63% of patients reduced their colonic irrigation rhythm.ConclusionsThe functional results of PCPC after APR improve and stabilize from 6 months to 1 year after surgery thus making PCPC a good alternative that surgeons can present to their patients.

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Impact of perineal pseudocontinent colostomy on perineal wound healing after abdominoperineal resection

Abstract: PPC accelerates perineal wound healing after APR without decreasing the overall perineal complication rate.

Cited by 12 publications

References 30 publications

A Systematic Review and Meta-analysis on Omentoplasty for the Management of Abdominoperineal Defects in Patients Treated for Cancer

A Systematic Review and Meta-analysis on Omentoplasty for the Management of Abdominoperineal Defects in Patients Treated for Cancer

Risk Factors of Poor Functional Results at 1-Year After Pseudocontinent Perineal Colostomy for Ultralow Rectal Adenocarcinoma

Functional outcomes over time following perineal pseudocontinent colostomy reconstruction after abdominoperineal resection for ultralow rectal adenocarcinoma

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