Aim An improvement in oncological outcome has been reported following an extralevator approach to abdominoperineal excision (ELAPE) for low rectal carcinoma. A larger perineal defect following ELAPE and the impact of neoadjuvant radiotherapy are sources of considerable morbidity for patients. We report an evidence-based systematic review of published data on the outcome of perineal reconstruction following ELAPE for low rectal carcinoma, comparing the use of tissue flap and biological mesh techniques. Method A literature search was performed of electronic databases including the Medline, Embase and Scopus databases (19952011). Studies describing outcomes relating to the perineum following ELAPE were included for review. Results Eleven small cohort studies reported the outcome relating to the perineum following ELAPE. Pooled-analysis of 255 combined patients undergoing flap repair and 85 undergoing biological mesh repair showed no significant difference in the rates of perineal wound complications or perineal hernia formation. Conclusion There is little information on the optimal technique of perineal wound closure following ELAPE. With the limited data available, there was no significant difference in complication rates between biological mesh and flap repair. There is a need for high-quality prospective trials to compare methods of reconstruction to determine the long-term results, quality of life and function.
机构:
Ersta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Karolinska Inst, Dept Mol Med & Surg, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Anderin, C.
Martling, A.
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h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Surg Gastroenterol, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Martling, A.
Lagergren, J.
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h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Plast & Reconstruct Surg, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Lagergren, J.
Ljung, A.
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h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Plast & Reconstruct Surg, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Ljung, A.
Holm, T.
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Surg Gastroenterol, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
机构:
Department of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Boccola M.A.
Rozen W.M.
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h-index: 0
机构:
Department of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Rozen W.M.
Ek E.W.
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h-index: 0
机构:
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Ek E.W.
Grinsell D.
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h-index: 0
机构:
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Grinsell D.
Croxford M.A.
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h-index: 0
机构:
Department of Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
机构:
Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, FranceUniv Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
Dehni, N
McFadden, N
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h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
McFadden, N
McNamara, DA
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h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
McNamara, DA
Guiguet, M
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h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
Guiguet, M
Tiret, E
论文数: 0引用数: 0
h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
Tiret, E
Parc, R
论文数: 0引用数: 0
h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
机构:
Ersta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Karolinska Inst, Dept Mol Med & Surg, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Anderin, C.
Martling, A.
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Surg Gastroenterol, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Martling, A.
Lagergren, J.
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Plast & Reconstruct Surg, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Lagergren, J.
Ljung, A.
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Plast & Reconstruct Surg, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
Ljung, A.
Holm, T.
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Surg Gastroenterol, Stockholm, SwedenErsta Hosp, Dept Surg, SE-11691 Stockholm, Sweden
机构:
Department of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Boccola M.A.
Rozen W.M.
论文数: 0引用数: 0
h-index: 0
机构:
Department of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Rozen W.M.
Ek E.W.
论文数: 0引用数: 0
h-index: 0
机构:
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Ek E.W.
Grinsell D.
论文数: 0引用数: 0
h-index: 0
机构:
Department of Plastic and Reconstructive Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
Grinsell D.
Croxford M.A.
论文数: 0引用数: 0
h-index: 0
机构:
Department of Surgery, Western Hospital, Footscray, VIC 3011, Gordon StDepartment of Surgery, Western Hospital, Footscray, VIC 3011, Gordon St
机构:
Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, FranceUniv Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
Dehni, N
McFadden, N
论文数: 0引用数: 0
h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
McFadden, N
McNamara, DA
论文数: 0引用数: 0
h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
McNamara, DA
Guiguet, M
论文数: 0引用数: 0
h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
Guiguet, M
Tiret, E
论文数: 0引用数: 0
h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France
Tiret, E
Parc, R
论文数: 0引用数: 0
h-index: 0
机构:Univ Paris 06, INSERM, Hosp St Antoine, Dept Digest Surg,U444, Paris, France