scholarly journals Transvaginal Small Bowel Evisceration following Abdominoperineal Resection

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Enver Kunduz ◽  
Huseyin Bektasoglu ◽  
Samet Yigman ◽  
Huseyin Akbulut
Keyword(s):  
Rectal Cancer ◽  
Small Bowel ◽  
Hernia Repair ◽  
Abdominoperineal Resection ◽  
Late Stage ◽  
Rare Case ◽  
Surgical Techniques ◽  
Perineal Hernia ◽  
Distal Rectal Cancer ◽  
Perineal Herniation

Abdominoperineal resection (APR) is one of the surgical techniques performed for the distal rectal cancer. The perineal herniation is one of the complications of APR surgery. In this report, we aim to demonstrate a rare case of small bowel evisceration and strangulation secondary to the transvaginal herniation evolved in the late stage after perineal hernia repair following laparoscopic APR.

scholarly journals Closed loop obstruction and adhesive intestinal obstruction in perineal hernia

2020 ◽  
Vol 13 (12) ◽  
pp. e238112
Author(s):  
Ramprasad Rajebhosale ◽  
Mohammad Miah ◽  
Fraser Currie ◽  
Pradeep Thomas
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Transition Point ◽  
Closed Loop ◽  
Abdominoperineal Excision ◽  
Perineal Hernia ◽  
Bowel Gangrene ◽  
Adhesive Intestinal Obstruction

Perineal hernia with bowel gangrene is uncommon but known complication of laparoscopic extralevator abdominoperineal excision (ELAPE). We present a rare case of closed loop small bowel obstruction with bowel gangrene secondary to an incarcerated perineal hernia that developed 7 years after an ELAPE. Intraoperatively, we found a definitive transition point due to adhesions in pelvis and a closed loop obstruction of the distal small bowel at different site with gangrenous intestine. She was managed successfully surgically with adhesiolysis and fixation of defect with biological mesh. Prevalence of perineal hernias will rise in future because of the increasing cases of ELAPE, in which no repair of pelvic floor is performed. The need of follow-up of these operations and more reporting of such cases are important in increasing awareness of these complications. Patients should be made aware of such complications and should seek urgent medical care.

Perineal Hernia Repair With Mesh After Robotic Abdominoperineal Resection

2019 ◽  
Vol 62 (8) ◽  
pp. 1013 ◽  
Author(s):  
Ipek Sapci ◽  
Jim P. Tiernan ◽  
Emre Gorgun
Keyword(s):  
Hernia Repair ◽  
Abdominoperineal Resection ◽  
Perineal Hernia

scholarly journals Intersphincteric Resection and Coloanal Anastomosis in Treatment of Distal Rectal Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Gokhan Cipe ◽  
Mahmut Muslumanoglu ◽  
Erkan Yardimci ◽  
Naim Memmi ◽  
Erhan Aysan
Keyword(s):  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Functional Outcomes ◽  
Coloanal Anastomosis ◽  
Intersphincteric Resection ◽  
Distal Rectal Cancer ◽  
Sphincter Saving ◽  
Resection Line ◽  
Alternative Choice

In the treatment of distal rectal cancer, abdominoperineal resection is traditionally performed. However, the recognition of shorter safe distal resection line, intersphincteric resection technique has given a chance of sphincter-saving surgery for patients with distal rectal cancer during last two decades and still is being performed as an alternative choice of abdominoperineal resection. The first aim of this study is to assess the morbidity, mortality, oncological, and functional outcomes of intersphincteric resection. The second aim is to compare outcomes of patients who underwent intersphincteric resection with the outcomes of patients who underwent abdominoperineal resection.

Distal cT2N0 Rectal Cancer: Is There an Alternative to Abdominoperineal Resection?

2005 ◽  
Vol 23 (22) ◽  
pp. 4905-4912 ◽  
Author(s):  
Ramesh Rengan ◽  
Philip Paty ◽  
W. Douglas Wong ◽  
Jose Guillem ◽  
Martin Weiser ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Pathologic Complete Response ◽  
Rectal Adenocarcinoma ◽  
Sphincter Preservation ◽  
External Beam Radiation ◽  
Cancer Center ◽  
Beam Radiation ◽  
Pelvic Radiation ◽  
Distal Rectal Cancer

Purpose Patients with cT2N0 distal rectal cancer do not require adjuvant therapy. However, when a patient refuses an abdominoperineal resection (APR), is there an alternative? The purpose of this trial is to determine whether preoperative external-beam radiation therapy can increase the rate of sphincter preservation for patients with distal cT2N0 adenocarcinoma of the rectum. Patients and Methods Between April 1988 and October 2003, 27 patients with distal rectal adenocarcinoma staged T2 by clinical and/or endorectal ultrasound who were judged by the operating surgeon to require an APR were treated with preoperative pelvic radiation alone (50.4 Gy). Surgery was performed 4 to 7 weeks later. If pathologic positive pelvic nodes were identified, postoperative adjuvant chemotherapy was recommended. The median follow-up was 55 months (range, 9 to 140 months). Results The pathologic complete response rate was 15% and 78% of patients underwent a sphincter-sparing procedure. The crude incidence of local failure for patients undergoing a sphincter sparing procedure was 10% and the 5-year actuarial incidence was 13%. The actuarial 5-year survival for patients undergoing sphincter preservation was as follows: disease-free, 77%; colostomy-free, 100%; and overall, 85%. Using the Memorial Sloan-Kettering Cancer Center sphincter function score, 54% of those undergoing a sphincter-sparing procedure had good/excellent bowel function at 12 to 24 months after surgery, and 77% had good/excellent function at 24 to 36 months after surgery. Conclusion Our data suggest that for patients with cT2N0 distal rectal cancer who require an APR, preoperative pelvic radiation improves sphincter preservation without an apparent compromise in local control or survival.

Long-term Quality of Life and Sexual and Urinary Function After Abdominoperineal Resection for Distal Rectal Cancer

2012 ◽  
Vol 55 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Michael S. Kasparek ◽  
Imran Hassan ◽  
Robert R. Cima ◽  
Dirk R. Larson ◽  
Rachel E. Gullerud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Urinary Function ◽  
Distal Rectal Cancer

Short-Term Outcomes of Pelvic Peritoneum Reconstruction with Barbed Suture After Laparoscopic Rectal Resection for Rectal Cancer

2021 ◽  
Author(s):  
Jing Wen ◽  
Jian Shen ◽  
Qiushi Huang ◽  
Shan He
Keyword(s):  
Rectal Cancer ◽  
Small Bowel ◽  
Lymph Nodes ◽  
Small Bowel Obstruction ◽  
Rectal Resection ◽  
Perineal Hernia ◽  
Barbed Suture ◽  
Short Term ◽  
Pelvic Peritoneum ◽  
Laparoscopic Rectal Resection

Abstract Background: Laparoscopic rectal resection may cause various surgical complications including perineal hernia and adhesive small-bowel obstruction. Pelvic peritoneum reconstruction (PPR) could prevent those complications. The aim of the study is to evaluate the short-term clinical, technical and safety outcomes of PPR using the barbed suture in laparoscopic rectal resection. Methods: This is a retrospective cohort study conducted in Chengdu second’s people hospital. Between January 2014 and December 2019, a total of 402 patients who underwent curative surgery for rectal cancer in Chengdu Second People’s Hospital were enrolled in the study. Among them, 216 patients who underwent laparoscopic rectal resection with PPR were allocated into the experimental group, and 186 patients who underwent laparoscopic rectal resection without PPR were allocated into control group. All the patients received standard preoperative and postoperative treatments. Observational indicators (1) surgical and postoperative conditions; (2) postoperative pathological examination. (3) postoperative complications. The data were represented by X ± s. t-test and X2 test were used for counting data. Results (1) Surgery condition: all patients in the two groups underwent successful surgery without conversion to open surgery. There were no differences between the two groups in terms of surgical approach, resection margin, tumor size, postoperative T-stage, postoperative N-stage, positive lymph nodes, harvest lymph nodes, perineal wound infection, perineal hernia, postoperative pneumonia, postoperative hemorrhage, presacral fluid, or abscess. The operative time, blood loss, the incidence of anastomotic leakage, and small-bowel obstruction showed a significant difference between the two groups. Conclusion We hypothesized that pelvic peritoneum reconstruction with barbed suture could improve the efficiency of intracorporeal closure of the pelvic cavity after in laparoscopic rectal resection, which can significantly reduce postoperative perineal-related complications. Further, we expect that use of the barbed sutures will reduce intra-operative stress on the endoscopic surgeon.

scholarly journals A comparative multicentre study evaluating gluteal turnover flap for wound closure after abdominoperineal resection for rectal cancer

2021 ◽  
Author(s):  
S. Sharabiany ◽  
J. J. W. van Dam ◽  
S. Sparenberg ◽  
R. D. Blok ◽  
B. Singh ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Wound Healing ◽  
Abdominoperineal Resection ◽  
Primary Closure ◽  
Healing Rate ◽  
Perineal Wound ◽  
Perineal Hernia ◽  
Perineal Wound Healing ◽  
Flap Closure ◽  
Wound Healing Rate

Abstract Background The aim of this study was to compare perineal wound healing between gluteal turnover flap and primary closure in patients undergoing abdominoperineal resection (APR) for rectal cancer. Methods Patients who underwent APR for primary or recurrent rectal cancer with gluteal turnover flap in two university hospitals (2016–2021) were compared to a multicentre cohort of primary closure (2000–2017). The primary endpoint was uncomplicated perineal wound healing within 30 days. Secondary endpoints were long-term wound healing, related re-interventions, and perineal herniation. The perineal hernia rate was assessed using Kaplan Meier analysis. Results Twenty–five patients had a gluteal turnover flap and 194 had primary closure. The uncomplicated perineal wound-healing rate within 30 days was 68% (17/25) after gluteal turnover flap versus 64% (124/194) after primary closure, OR 2.246; 95% CI 0.734–6.876; p = 0.156 in multivariable analysis. No major wound complications requiring surgical re-intervention occurred after flap closure. Eighteen patients with gluteal turnover flap completed 12-month follow-up, and none of them had chronic perineal sinus, compared to 6% (11/173) after primary closure (p = 0.604). The symptomatic 18-month perineal hernia rate after flap closure was 0%, compared to 9% after primary closure (p = 0.184). Conclusions The uncomplicated perineal wound-healing rate after the gluteal turnover flap and primary closure after APR is similar, and no chronic perineal sinus or perineal hernia occurred after flap closure. Future studies have to confirm potential benefits of the gluteal turnover flap.

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