APEMESH- Preventing Perineal Complications After Abdominoperineal Resection

APEMESH- Preventing Perineal Complications After Abdominoperineal Resection

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.

Inclusion Criteria:

• Abdominoperineal resection and permanent colostoma

Exclusion Criteria:

• Patient with a comorbid illness of condition that would preclude the use of surgery (ASA5)
• Potentially curable resection not possible
• Patient undergoing emergency procedure
• Metastatic disease
• Pregnant or suspected pregnancy