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News

Wound healing after abdominoperineal resection for rectal cancer

September's issue of the Diseases of the Colon & Rectum examines perineal wound healing after abdominoperineal resection for rectal cancer.

News image

Impaired perineal wound healing has become a significant clinical problem after abdominoperineal resection for rectal cancer.

The increased use of neoadjuvant radiotherapy and wider excisions might have contributed to this problem.

Dr Gijsbert Musters and colleagues performed a systematic review with meta-analysis to determine the impact of radiotherapy, and an extralevator approach on perineal wound healing after abdominoperineal resection for rectal cancer.

The team identified studies describing any outcome measure on perineal wound healing after abdominoperineal resection for rectal cancer.

The researchers' primary end point was overall perineal wound problems within 30 days after conventional or extralevator abdominoperineal resection with or without neoadjuvant radiotherapy.

Secondary end points were primary wound healing, perineal hernia rate, and the effect of biological mesh closure on perineal wound problems.

The percentage of perineal wound problems was 7%
Diseases of the Colon & Rectum

A total of 32 studies were included.

The team found that the pooled percentage of perineal wound problems after primary perineal wound closure in patients who did not undergo neoadjuvant radiotherapy was 15% after conventional abdominoperineal resection, and 15% after extralevator abdominoperineal resection.

After neoadjuvant radiotherapy, perineal wound problems occurred in 30% after conventional abdominoperineal resection, and in 38% after extralevator abdominoperineal resection.

Radiotherapy significantly increased perineal wound problems after abdominoperineal resection.

After biological mesh closure of the pelvic floor following extralevator abdominoperineal resection with neoadjuvant radiotherapy, the percentage of perineal wound problems was 7%.

Dr Musters' team concludes, "Neoadjuvant radiotherapy significantly increases perineal wound problems after abdominoperineal resection for rectal cancer, whereas the extralevator approach seems not to be of significant importance."

Dis Colon Rectum 2014: 57(9): 1129–1139
26 August 2014

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