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Pelvic floor reconstruction with a biological mesh after extralevator abdominoperineal excision leads to few perineal hernias and acceptable wound complication rates with minor movement limitations

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Authors:
  • Jensen, K K ;
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    Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet
  • Rashid, L ;
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    unknown
  • Pilsgaard, B ;
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    unknown
  • Møller, P ;
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    unknown
  • Wille-Jørgensen, P
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    Section of Surgery and Internal Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet
Subtitle:
single-centre experience including clinical examination and interview
DOI:
10.1111/codi.12492
Abstract:
AIM: The aim of the study was to describe long-term subjective and objective results of pelvic floor reconstruction using an absorbable biological mesh after extralevator abdominoperineal excision (ELAPE) for low rectal cancer. METHOD: Records of 53 patients who had an ELAPE with reconstruction of the pelvic floor with a Permacol® mesh between August 2007 and August 2011 were reviewed. Thirty-one of the patients were called for interview and clinical examination. RESULTS: Three (6%) patients developed perineal hernia, 11 had fistulae (nine of which were treated successfully), four patients had a perineal abscess and four patients had superficial wound infections. Removal of the mesh was necessary in one case, while another patient needed implantation of a new mesh. In 13 of the 31 interviewed patients, long-term pain was present, but resolved after a median of 8 months (3-56). No major sitting or movement disabilities were encountered. Three-year survival was 82%, and no local recurrences were found. CONCLUSION: Pelvic floor reconstruction with a biological mesh is a feasible solution when performing ELAPE for low rectal cancer, although long-term pain is a frequent complication.
Type:
Journal article
Language:
English
Published in:
Colorectal Disease, 2014, Vol 16, Issue 3, p. 192-197
Keywords:
Abscess; Adult; Aged; Aged, 80 and over; Biocompatible Materials; Chronic Pain; Cohort Studies; Collagen; Cutaneous Fistula; Female; Hernia; Humans; Male; Middle Aged; Pelvic Floor; Perineum; Postoperative Complications; Rectal Neoplasms; Retrospective Studies; Surgical Mesh; Surgical Wound Infection; Treatment Outcome; Journal Article
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2014
Scientific Level:
Scientific
ID:
260146430

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