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Short- and mid-term outcomes of abdominoperineal resection with perineal mesh insertion: a single-centre experience. | LitMetric

AI Article Synopsis

  • Abdominoperineal resection (APR) is an important surgical procedure for treating low rectal cancers, but closing the perineal wound effectively can be difficult, especially with extralevator APR (ELAPR) due to tissue gaps.
  • This study reviewed the outcomes of 49 patients who received APR with perineal mesh closure over a six-year period, highlighting patient demographics, surgical techniques, and complication rates.
  • The results indicated a 30% infection rate for perineal wounds and a solid overall survival rate of 91%, suggesting that using mesh for wound closure leads to positive short- and medium-term outcomes.

Article Abstract

Purpose: Abdominoperineal resection (APR) remains a key procedure for the treatment of low rectal/anorectal cancers. However, perineal wound closure remains challenging, particularly in extralevator abdominoperineal resection (ELAPR) due to gapped tissue planes. Different approaches have been attempted to improve perineal wound repair. The aim of this study is to report our 6-year experience in perineal wound closure utilising biological mesh.

Methods: We conducted a retrospective study using data from our prospectively maintained database, including patients who underwent APR with perineal mesh closure between 2016 and 2021.

Results: 49  patients underwent APR with perineal mesh reconstruction for low rectal cancer during the 6-year period. Of these, 63% were males, with a mean age of 68 (± 11), and a mean BMI of 27.9 (± 13.7). 49% (24) of patients received neoadjuvant therapy. 88% (43) of patients underwent standard "S-APR" and only 12% (6) underwent ELAPR. Majority of procedures were laparoscopic (87.8%) with conversion rate of 6.9%. Mean length of stay was 11.7 (± 11.6). The perineal wound infection rate was 30% and only two patient required mesh removal due to entero-cutaneous perineal fistula and pelvic abscess. Perineal hernia was found in only two patients (4.1%). CRM was negative in 81.6% of the patients. Mean follow-up period was 29.2 (± 16.5) months, and disease recurrence occurred in 9 (18.3%) patients with average number of months for recurrence of 21 (± 7). Overall survival during the follow-up period was 91%.

Conclusion: Our series shows a favourable short- and medium-term outcome with routine insertion of mesh for perineal wound closure.

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Source
http://dx.doi.org/10.1007/s00384-023-04507-5DOI Listing

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