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Recenzirano
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Spasojevic, Milan; Mariathasan, Anthony B.; Goscinski, Mariusz; Thorgersen, Ebbe B.; Solbakken, Arne M.; Gullestad, Hans-Petter; Ryder, Truls; Flatmark, Kjersti; Larsen, Stein G.
Annals of surgical oncology, 05/2018, Letnik: 25, Številka: 5Journal Article
Background Radiotherapy (RT) and subsequent abdominoperineal resection (APR) for locally advanced rectal cancer (LARC) is associated with significant perineal wound morbidity. The aim of the present study was to investigate if vertical rectus abdominis musculocutaneous (VRAM) flap repair after APR in LARC patients improves perineal wound healing compared with direct perineal wound closure (non-VRAM). Methods LARC patients ( n = 329) operated with APR between January 2006 and December 2015 after neoadjuvant RT of ≥ 25 Gy were identified, including 260 and 69 patients in the non-VRAM and VRAM groups, respectively. Perineal wound healing was assessed 3 months postoperatively, and risk factors for perineal wound complications and associations with short- and long-term outcome were analyzed. Results Delayed perineal wound healing after 3 months was more frequent in the non-VRAM group (31.5%) compared with the VRAM group (10.4%) ( p < 0.01). In the non-VRAM group, 26.9% of patients developed pelvic abscess, compared with 10.1% in the VRAM group ( p < 0.01). Significant risk factors for perineal wound morbidity were non-VRAM (odds ratio OR 3.94, 95% confidence interval CI 1.72–9.00; p = 0.02), positive circumferential resection margin (R1; OR 3.64, 95% CI 1.91–6.93; p < 0.01), pelvic abscess (OR 3.27, 95% CI 1.90–5.63; p < 0.01), and short-course RT (OR 3.81, 95% CI 1.75–8.30; p < 0.01). Perineal wound morbidity was not associated with impaired long-term oncologic outcome. Conclusions VRAM flap reconstruction of the perineum is associated with an increased wound healing rate and may protect against pelvic abscess development. However, procedure-related long-term morbidity is incompletely studied and the procedure should be reserved for selected patients.
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Dostop do baze podatkov JCR je dovoljen samo uporabnikom iz Slovenije. Vaš trenutni IP-naslov ni na seznamu dovoljenih za dostop, zato je potrebna avtentikacija z ustreznim računom AAI.
Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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