ORDA - Online Research Data Archive 
    • Login
    View Item 
    •   ORDA Home
    • University Hospitals of Derby and Burton NHS Foundation Trust
    • Division of Medicine
    • Specialist Medicine
    • View Item
    •   ORDA Home
    • University Hospitals of Derby and Burton NHS Foundation Trust
    • Division of Medicine
    • Specialist Medicine
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Biological mesh reconstruction of perineal wounds following enhanced abdominoperineal excision of rectum (APER).

    Thumbnail
    Abstract
    INTRODUCTION: An abdominoperineal excision of rectum (APER) may be required for rectal tumours less than 6 cm from the anal verge. Recently, the cylindrical APER has been used to prevent the "surgical waist" and so decrease margin involvement. However, removal of the levators leaves a large defect. Myocutaneous flaps [e.g. vertical rectus abdominis (VRAM)] are often used to fill the cylindrical resection defect, but have disadvantages associated with operative time, expertise and morbidity. We report our early experience of pelvic floor reconstruction with a biological mesh following cylindrical APER. METHODS: Data on consecutive patients having cylindrical APER between January 2008 and November 2010 were collected. Outcomes were compared between a VRAM reconstruction group and a mesh group. RESULTS: In 15 consecutive patients with low rectal cancer, five patients had VRAM pelvic floor reconstruction prior to ten patients having biosynthetic mesh repairs. The median operative time for the VRAM cohort was 405 min, compared with 259 min for the mesh (p = 0.0013). The median length of postoperative stay was 20 days for VRAM and 10 days for the mesh group (p = 0.067). There were four early complications for the VRAM group compared with seven for the mesh cohort (p = 0.37). The median cost per patient for the VRAM cohort was £11,075 compared to a median cost of £6,513 for the Mesh (p = 0.0097). CONCLUSION: The use of a biological mesh for pelvic floor reconstruction following cylindrical APER is feasible with morbidity comparable to VRAM reconstruction. There is significant cost-saving using a biosynthetic mesh, mainly due to reduced length of stay.
    URI
    https://orda.derbyhospitals.nhs.uk/handle/123456789/503
    Collections
    • Specialist Medicine [375]
    Date
    2012-04
    Author
    Peacock, Oliver
    Pandya, H
    Sharp, T
    Hurst, NG
    Speake, WJ
    Tierney, Gillian
    Lund, Jonathan
    Show full item record

    copyright © 2017  Derby Teaching Hospitals NHS Foundation Trust
    Contact Us | Send Feedback
    Powered by KnowledgeArc
     

     

    Browse

    All of ORDACommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    Researcher Profiles

    Researchers

    My Account

    Login

    copyright © 2017  Derby Teaching Hospitals NHS Foundation Trust
    Contact Us | Send Feedback
    Powered by KnowledgeArc