Perineal reconstruction after extralevator abdominoperineal excision (ELAPE) for carcinoma at the lower rectum

VernacularTitle:低位直肠癌肛提肌外腹会阴联合直肠切除术后的盆底修复
Author: Zhenjun WANG ¹ ; Jiagang HAN
Author Information

1. 100020,首都医科大学附属北京朝阳医院普通外科
Keywords: Rectal neoplasms; Extralevator abdominoperineal excision; Pelvic defect; Pelvic restoration
From: Chinese Journal of Gastrointestinal Surgery 2014;(6):540-543
CountryChina
Language:Chinese
Abstract: Extralevator abdominoperineal excision (ELAPE) has been described to improve the outcomes of advanced low rectal cancer, probably because of more pelvic dissection and less positive circumferential resection margin (CRM). Recent improvements of ELAPE have focused on the reconstruction of the large pelvic defect. Different approaches have been focused on the reconstruction including primary closure, uterus retroversion, omentoplasty, myocutaneous flaps, and biological mesh. The optimal method is still controversial. Recent reviews showed that the perineal wound complications of biological mesh reconstruction were comparable to those of myocutaneous flaps. Moreover reviews suggested the use of biologic materials to close the perineal defect because it offers a significant cost saving mostly attributable to reduction in hospital length of stay. The combination of different techniques may be the best way to reconstruct the pelvic defect following ELAPE.