The objective of this pilot study is to assess the safety, functional outcome, feasibility and the potential benefits of synthetic mesh strip and gluteus flap reconstruction in perineum in case-control setting.

Several studies have reported over 30% morbidity with perineal wound healing after abdominoperineal resection. Preoperative radiotherapy seems to be a strong predictor for perineal complications. Musculocutaneus flaps and use of biological mesh seem to minimize perineal morbidity.

Inclusion Criteria:

• Curative intent abdominoperineal resection and permanent colostomy

Exclusion Criteria:

• Patient with a comorbid illness or condition that would preclude the use of surgery (ASA 4- 5)
• Immunosupression (cortisone >10mg/day) or severe malnutrition (BMI <20)
• Diabetes with 1 or more organ damage
• Dialysis treatment
• Hepatic cirrhosis Child-Bugh B-C
• Potentially curable resection not possible
• Patient undergoing emergency procedures
• Metastatic disease
• Vaginal resection, pelvic exenteration and sacrum resection
• Vaginal perforation
• Pelvic abscess or perforated tumor
• Pregnant or suspected pregnancy