Abstract:
BACKGROUND:Current 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®, Biodesign™) reconstruction following ELAPER. METHODS:A 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). RESULTS:One 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%. CONCLUSIONS:This 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.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
Thomas PW,Blackwell JEM,Herrod PJJ,Peacock O,Singh R,Williams JP,Hurst NG,Speake WJ,Bhalla A,Lund JNdoi
10.1007/s10151-019-02056-0subject
Has Abstractpub_date
2019-08-01 00:00:00pages
761-767issue
8eissn
1123-6337issn
1128-045Xpii
10.1007/s10151-019-02056-0journal_volume
23pub_type
杂志文章abstract::Advancements in minimally invasive surgery have both revolutionized laparoscopy and set the stage for the advancement of endoscopic surgery to the forefront of modern medicine. Natural orifice transluminal endoscopic surgery (NOTES) has now become a subject of great interest to surgeons worldwide who wish to reduce th...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-012-0934-2
更新日期:2013-02-01 00:00:00
abstract::Advancements in the medical treatment of Crohn's disease have reduced the need for surgery. The indications for surgery include the failure of medical management, especially the persistence or worsening of symptoms in spite of proper treatment and complications of the disease process. These complications include intes...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0728-y
更新日期:2011-10-01 00:00:00
abstract::Anal fistula repair still remains challenging. Up to 30% of fistulas persist after surgery despite many improvements in surgical skills and technique. One major reason for surgical failure is a persistent fistula track or remnants of the fistula epithelium which could not be removed during surgery. To overcome this pr...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0726-0
更新日期:2011-12-01 00:00:00
abstract::Laparoscopic colectomy for cancer is increasingly practiced worldwide in the last 2 decades. However, due to procedural complexity, laparoscopic rectal cancer excision had not proceeded at a similar pace. This article deals with the technique of laparoscopic anterior resection. Resection of rectosigmoid or upper recta...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0557-4
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:This study was performed to determine impact of open and hand-assisted colorectal resection on surgical site infection (SSI) rates. METHODS:National Surgical Quality Improvement Project data from 2006 to 2008 were supplemented with an institutional review board-approved chart review. Primary endpoint was SSI r...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1066-z
更新日期:2014-04-01 00:00:00
abstract::Colorectal cancer (CRC) is the leading cause of cancer-related mortality in western countries. Adjuvant treatment does not seem to be highly effective and recurrent or metastatic disease occurs in half of the new cases within one year of diagnosis and median survival does not exceed 18 months. CRC represents an optima...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-004-0170-5
更新日期:2004-12-01 00:00:00
abstract::This article describes the operative technique that my colleagues and I apply to total mesorectal excision in patients with rectal cancer. A body of data support improvement of short-term outcomes over open resection. Although long-term data remain scarce, several ongoing trials may clarify this deficiency. The approp...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-012-0932-4
更新日期:2013-02-01 00:00:00
abstract::This technical note presents a variation of the stapled mucosal prolapsectomy for haemorrhoidal prolapse using the Lone Star Retractor. Our experience highlights the simplicity and usefulness of the technique which is based on the complete eversion of the prolapse carried out by the Lone Star Retractor, without using ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/pl00012123
更新日期:2001-04-01 00:00:00
abstract::Colorectal cancer (CRC) is the second leading cause of cancer-related morbidity and mortality in Europe and the United States. Planning for a CRC screening began in co-operation with local authorities (Pella Prefecture sponsored test kits). Our aims were to develop a screening programme for colorectal cancer using the...
journal_title:Techniques in coloproctology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s10151-004-0154-s
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:The aim of our study was to assess perineal wound healing in patients with Crohn's disease (CD) who undergo proctectomy or proctocolectomy with end ileostomy and to evaluate the influence of various factors including types of perineal dissection on eventual wound healing. METHODS:Data for patients with CD w...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-017-1695-8
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Various predictors of perioperative risk for patients with rectal cancer undergoing radical resection have been well described, but no simple scoring system for surgeons to estimate this risk currently exists. The objective of this study was to develop a system for more accurate preoperative evaluations of c...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1076-x
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The proposed difficulty scoring system (DSS) may aid in preoperative planning for laparoscopic total mesorectal excision (L-TME) for rectal cancer. METHODS:Fifty-three patients [28 males; 59.0 (31.0-88.0) years of age] treated for rectal cancer at our institution from 2/2011-5/2018 were identified. "Difficu...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02285-8
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Fibre is often recommended as the first-choice treatment but its effects can be uneven. The aim of the study was to compare the clinical efficacy and tolerability of fibre versus lactulose in outpatients with chronic constipation. METHODS:In a prospective randomized crossover trial, patients were randomized...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10151-006-0262-5
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Technical factors affect oncologic outcomes in rectal cancer surgery. The anatomy of the bony pelvis can affect technical aspects of surgery, but is seldom considered preoperatively. We performed a morphometric analysis of the bony pelvis in patients having rectal cancer resection to assess its effect on sur...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02273-y
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Oncologic outcomes after complete mesocolic excision (CME) in colon cancer are under investigation. The aim of our study was to compare CME and conventional colectomy (CC) in terms of pathological and oncological outcomes for right colon cancer and to evaluate the impact of lymph node metastasis around the v...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02378-4
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Extralevator abdominoperineal excision (ELAPE) probably improves the oncological quality of low rectal cancer surgery, as compared to standard abdominoperineal excision (SAPE), possibly due to lower rates of accidental perioperative bowel perforations and lower rates of circumferential resection margin (CRM)...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-014-1243-8
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:A prospective randomized trial to assess the cleansing ability and tolerance of bowel preparations for colonoscopy was conducted in a group of 953 patients. METHODS:The bowel cleansing methods were: sennoside calcium, polyethylene glycol (PEG) lavage, oral sodium phosphate (NaP) in one 90-ml dose, oral NaP ...
journal_title:Techniques in coloproctology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s101510300003
更新日期:2003-04-01 00:00:00
abstract::The currently used technology for transanal excision of rectal neoplasms is diathermy. However, control of bleeding is sometimes difficult. The Harmonic Scalpel provides a "dry" surgical field which facilitates the procedure and allows complete resection of the neoplasm with greater accuracy. ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-008-0427-5
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Doppler-guided hemorrhoidal artery ligation (DGHAL) was described as lower risk and a less painful alternative to hemorrhoidectomy. We report our experience and 5-year follow-up with this procedure. METHODS:Between May 2003 and December 2004, 100 patients with symptomatic Grade II or III hemorrhoids underwe...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0801-6
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterized by abdominal discomfort, pain and changes in bowel habits, often associated with psychological/psychiatric disorders. It has been suggested that the development of IBS may be related to the body's response to ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-013-1106-8
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:The use of biological materials for the repair of complex abdominal wall defects has increased over the years; however, the role of these materials in routine practice remains unclear. The aim of the study was to evaluate clinical outcomes following the use of Permacol™ porcine collagen surgical implant in c...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-015-1307-4
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Accurate delineation of anal fistula anatomy in recurrent cases will assist in surgical fistula eradication whilst preserving continence. Recently, transperineal ultrasonography (TPUS) has been used in perirectal inflammation where there may be advantage over endoanal ultrasonography (EAUS) in complex fistul...
journal_title:Techniques in coloproctology
pub_type: 临床试验,杂志文章
doi:10.1007/s10151-006-0296-8
更新日期:2006-12-01 00:00:00
abstract::We present a new video-assisted minimally invasive technique for the treatment of pilonidal disease (E.P.Si.T: endoscopic pilonidal sinus treatment). Between March and November 2012, we operated on 11 patients suffering from pilonidal disease. Surgery is performed under local or spinal anesthesia using the Meinero fis...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1016-9
更新日期:2014-04-01 00:00:00
abstract::The Malone appendicostomy is a novel option for surgical management of faecal incontinence and chronic constipation, by permitting the administration of antegrade colonic enemas for colonic evacuation. We report the case of a 54-year-old female who had undergone abdomino perineal resection for low rectal cancer follow...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0672-2
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Perioperative blood transfusion has been associated with a poor prognosis in patients undergoing surgery for colorectal cancer. The aim of this study was to evaluate risk factors for blood transfusion and its impact on long-term outcome exclusively in patients undergoing laparoscopic surgery for curable colo...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1014-y
更新日期:2013-10-01 00:00:00
abstract::Prolapse is a common complication in patients with a transverse loop colostomy. In most cases, the prolapse can be managed conservatively awaiting time for closure eventually. However, loop stoma may also be intentionally permanent or the patient may be too fragile to have the colostomy closed and in these cases a lap...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0051-y
更新日期:2004-03-01 00:00:00
abstract::Prompt and appropriate referrals to colorectal surgeons result in better clinical and more cost-effective outcome: the question that then arises is how patients with large bowel diseases get in contact with the specialist. The aim of the present research was to investigate the sources of clinical referrals of 1000 pat...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s101510170001
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Epidemiological studies in Western countries have documented an increase of hospitalizations for acute diverticulitis (AD) but Italian evidence is scarce. The aim of the present study was to analyse the trend in hospitalization for AD, including in-hospital mortality, in Italy from 2008 to 2015. METHODS:Thr...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-018-1840-z
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:In Western countries, the incidence of acute diverticulitis (AD) is increasing. Patients with uncomplicated diverticulitis can undergo a standard antibiotic treatment in an outpatient setting. The aim of this systematic review was to assess the safety and efficacy of the management of acute diverticulitis in...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,meta分析
doi:10.1007/s10151-018-1919-6
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:In the United States, colorectal cancer (CRC) screening and surveillance is recommended until age 75. However, rates of surgery for CRC are greatest in the elderly, questioning current guidelines. Tumor sidedness is an emerging prognostic marker that may help guide screening and treatment decisions, with spe...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02329-z
更新日期:2020-08-27 00:00:00