Observational studyTechniques in coloproctology2019
Long-term outcomes of biological mesh repair following extra levator abdominoperineal excision of the rectum: an observational study of 100 patients.
Observational study in Techniques in coloproctology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Perineal wound complications after vertical rectus abdominis myocutaneous flap and mesh closure following abdominoperineal surgery and pelvic exenteration of anal and rectal cancers: A meta-analysis.International wound journal · 2023Pooled it
- A comparison of surgical techniques for perineal wound closure following perineal excision: a systematic review and network meta-analysis.Techniques in coloproctology · 2023Pooled it
- Comparison of perineal morbidity between biologic mesh reconstruction and primary closure following extralevator abdominoperineal excision: a systematic review and meta-analysis.International journal of colorectal disease · 2021Pooled it
- Meta-analysis of biological mesh reconstruction versus primary perineal closure after abdominoperineal excision of rectal cancer.International journal of colorectal disease · 2021Pooled it
- Perineal infection and risk factors following extralevator abdominoperineal excision and reconstruction with an absorbable synthetic prosthesis.Updates in surgery · 2026Observational
- Perineal hernia following extra-levator abdominoperineal resection: prevalence, associated risk factors and types of perineal closure. a single-centre descriptive study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Personalized Decisional Algorithms for Soft Tissue Defect Reconstruction after Abdominoperineal Resection for Low-Lying Rectal Cancers.Current oncology (Toronto, Ont.) · 2024Article
- Extracellular Matrix Scaffold-Assisted Tumor Vaccines Induce Tumor Regression and Long-Term Immune Memory.Advanced materials (Deerfield Beach, Fla.) · 2024Article
- Short- and mid-term outcomes of abdominoperineal resection with perineal mesh insertion: a single-centre experience.International journal of colorectal disease · 2023Article
- Is it worthwhile to perform closure of the pelvic peritoneum in laparoscopic extralevator abdominoperineal resection?Langenbeck's archives of surgery · 2022Article
- Efficacy of Pelvic Peritoneum Closure After Laparoscopic Extralevator Abdominoperineal Excision for Rectal Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- [Prophylaxis of parastomal, perineal and incisional hernias in colorectal surgery].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Review
- Case Report: Biologic graft placement with subsequent radiation therapy following radical vulvectomy for adenoid cystic carcinoma of the Bartholin's gland.Gynecologic oncology reports · 2021Article
- Review
- A low incidence of perineal hernia when using a biological mesh after extralevator abdominoperineal excision with or without pelvic exenteration or distal sacral resection in locally advanced rectal cancer patients.Techniques in coloproctology · 2020Article
- Article
- Extralevator abdominoperineal excision for advanced low rectal cancer: Where to go.World journal of gastroenterology · 2020Review
- Combined use of a petal flap and V-Y advancement flap for reconstruction of presacral defects following rectal resection.Techniques in coloproctology · 2020Article
- Feasibility of a subcutaneous gluteal turnover flap without donor site scar for perineal closure after abdominoperineal resection for rectal cancer.Techniques in coloproctology · 2019Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent evidence suggests that pelvic floor reconstruction following extralevator abdominoperineal excision of rectum (ELAPER) may reduce the risk of perineal herniation of intra-abdominal contents. Options for reconstruction include mesh and myocutaneous flaps, for which long-term follow-up data is lacking. The aim of this study was to evaluate the long-term outcomes of biological mesh (Surgisis
methodsA retrospective review of all patients having ELAPER in a single institution between 2008 and 2018 was perfomed. Clinic letters were scrutinised for wound complications and all available cross sectional imaging was reviewed to identify evidence of perineal herniation (defined as presence of intra-abdominal content below a line between the coccyx and the lower margin of the pubic symphysis on sagittal view).
resultsOne hundred patients were identified (median age 66, IQR 59-72 years, 70% male). Median length of follow-up was 4.9 years (IQR 2.3-6.7 years). One, 2- and 5-year mortality rates were 3, 8 and 12%, respectively. Thirty three perineal wounds had not healed by 1 month, but no mesh was infected and no mesh needed to be removed. Only one patient developed a symptomatic perineal hernia requiring repair. On review of imaging a further 7 asymptomatic perineal hernias were detected. At 4 years the cumulative radiologically detected perineal hernia rate was 8%.
conclusionsThis study demonstrates that pelvic floor reconstruction using biological mesh following ELAPER is both safe and effective as a long-term solution, with low major complication rates. Symptomatic perineal herniation is rare following mesh reconstruction, but may develop sub clinically and be detectable on cross-sectional imaging.
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