Abdominoperineal resection leaves an empty space to be filled by mesh or musculocutaneus flap. Several studies have reported over 30% morbidity with perineal wound healing after abdominoperineal resection. Preoperative radiotherapy is a strong predictor for perineal complications. Musculocutaneus flaps and use of biological mesh seem to minimize perineal morbidity. The role of omentoplasty at APR is controversial. Previous studies on synthetic mesh repair on perineum are almost lacking.
The objective of this pilot study is to assess the feasibility and the potential benefits of synthetic mesh reconstruction in perineum in case-control setting. 30 subjects will be prospectively enrolled to this study as intervention group. Controls matched with age, gender and preoperative radiotherapy are selected from retrospective data collected from Oulu University database and operated for rectal adenocarcinoma 2009-2017 with otherwise identical methods.
Study Type
OBSERVATIONAL
Enrollment
30
Pelvic floor is reconstructed by synthetic composite mesh (Symbotex, Medtronic) to improve healing and prevent perineal herniation.
Oulu University Hospital
Oulu, Finland
Comprehensive Complication index
Comprehensive Complication index is used to evaluate outcome
Time frame: 30 days
Surgical site infection
Surgical site infection classified by Clavien-Dindo score
Time frame: 30 days
Reoperation rate
Reoperations during primary stay at the hospital
Time frame: 30 days
Operative time
Operative time
Time frame: 30 days
Length of stay
Length of stay at the hospital during primary operation and recovery
Time frame: 30 days
Costs
Costs by materials used
Time frame: 30 days
Total perineal healing time
Time to point when perineum is closed and healed
Time frame: 30 days
Perineal sinus
Presence of perineal sinus at 30 days follow-up
Time frame: 30 days
Perineal hernia
Perineal hernia by CT scan at 12 months follow-up
Time frame: 12 months
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