SynthesisInternational journal of colorectal disease2021
Meta-analysis of biological mesh reconstruction versus primary perineal closure after abdominoperineal excision of rectal cancer.
Synthesis in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Article
- 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
- Impact of perineal healing on oncological outcome following surgery for squamous cell carcinoma of the anus.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Risk Factors for Anastomotic Leakage: A Comprehensive Single-Center Analysis of Colorectal Anastomoses for Ovarian and Gastrointestinal Cancers.Annals of surgical oncology · 2025Article
- Article
- Fournier's gangrene due to rectal cancer: A case report.Molecular and clinical oncology · 2024Article
- Surgical Treatment of Low-Lying Rectal Cancer: Updates.Annals of coloproctology · 2021Review
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtralevator abdominoperineal excision (ELAPE) of rectal cancer has been proposed to achieve better oncological outcomes. The resultant wide perineal wound, however, presents a challenge for primary closure and subsequent wound healing. This meta-analysis compared the outcomes of primary perineal closure with those of biological mesh reconstruction.
methodsThe Medline and Embase search was performed for the publications comparing primary perineal closure to biological mesh reconstruction. Early perineal wound complications (seroma, infection, dehiscence) and late perineal wound complications (perineal hernia, chronic pain, and chronic sinus) were analyzed as primary endpoints. Intraoperative blood loss, operation time, and hospital stay were compared as secondary endpoints.
resultsThere was no significant difference in the overall early wound complications after primary closure or biological mesh reconstruction (odds ratio (OR) of 0.575 with 95% confidence interval (CI) of 0.241 to 1.373 and a P value of 0.213). The incidence of perineal hernia after 1 year was significantly high after primary closure of the perineal wounds (OR of 0.400 with 95% CI of 0.240 to 0.665 and a P value of 0.001). No significant differences were observed among other early and late perineal wound complications. The operation time and hospital stay were shorter after primary perineal closure (p 0.001).
conclusionA lower incidence of perineal hernia and comparable early perineal wound complications after biological mesh reconstruction show a relative superiority over primary closure. More randomized studies are required before a routine biological mesh reconstruction can be recommended for closure of perineal wounds after ELAPE.
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