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: single-centre experience including clinical examination and interview

TY - JOUR

T1 - 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

T2 - single-centre experience including clinical examination and interview

AU - Jensen, K K

AU - Rashid, L

AU - Pilsgaard, B

AU - Møller, P

AU - Wille-Jørgensen, P

N1 - Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

PY - 2014/3

Y1 - 2014/3

N2 - 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.

AB - 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.

KW - Abscess

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biocompatible Materials

KW - Chronic Pain

KW - Cohort Studies

KW - Collagen

KW - Cutaneous Fistula

KW - Female

KW - Hernia

KW - Humans

KW - Male

KW - Middle Aged

KW - Pelvic Floor

KW - Perineum

KW - Postoperative Complications

KW - Rectal Neoplasms

KW - Retrospective Studies

KW - Surgical Mesh

KW - Surgical Wound Infection

KW - Treatment Outcome

U2 - 10.1111/codi.12492

DO - 10.1111/codi.12492

M3 - Journal article

C2 - 24251666

SN - 1462-8910

VL - 16

SP - 192

EP - 197

JO - Colorectal Disease

JF - Colorectal Disease

IS - 3

ER -