Schiltz B, Buchs NC, Penna M, Scarpa CR, Liot E, Morel P, Ris F. Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review. World J Clin Oncol 2017; 8(3): 249-254 [PMID: 28638794 DOI: 10.5306/wjco.v8.i3.249]
Corresponding Author of This Article
Boris Schiltz, MD, Division of Visceral Surgery, Department of Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. boris.schiltz@hcuge.ch
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jun 10, 2017; 8(3): 249-254 Published online Jun 10, 2017. doi: 10.5306/wjco.v8.i3.249
Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review
Boris Schiltz, Nicolas Christian Buchs, Marta Penna, Cosimo Riccardo Scarpa, Emilie Liot, Philippe Morel, Frederic Ris
Boris Schiltz, Nicolas Christian Buchs, Cosimo Riccardo Scarpa, Emilie Liot, Philippe Morel, Frederic Ris, Division of Visceral Surgery, Department of Surgery, University Hospitals of Geneva, 1205 Geneva, Switzerland
Marta Penna, Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Headington, Oxford OX3 7LE, United Kingdom
Author contributions: Schiltz B, Buchs NC and Morel P designed the research; Schiltz B, Buchs NC, Scarpa CR and Liot E performed the research (local data and literature review); Schiltz B, Buchs NC, Penna M, Liot E and Ris F interpreted the data; Morel P and Ris F revised the article; all authors gave their final approval.
Conflict-of-interest statement: None of the authors have conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Boris Schiltz, MD, Division of Visceral Surgery, Department of Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. boris.schiltz@hcuge.ch
Telephone: +41-79-5534161 Fax: +41-22-3727707
Received: January 28, 2017 Peer-review started: February 10, 2017 First decision: March 28, 2017 Revised: April 12, 2017 Accepted: May 12, 2017 Article in press: May 14, 2017 Published online: June 10, 2017
Abstract
Extralevator abdominoperineal excision and pelvic exenteration are mutilating operations that leave wide perineal wounds. Such large wounds are prone to infection and perineal herniation, and their closure is a major concern to most surgeons. Different approaches to the perineal repair exist, varying from primary or mesh closure to myocutaneous flaps. Each technique has its own associated advantages and potential complications and the ideal approach is still debated. In the present study, we reviewed the current literature and our own local data regarding the use of biological mesh for perineal wound closure. Current evidence suggests that the use of biological mesh carries an acceptable risk of wound complications compared to primary closure and is similar to flap reconstruction. In addition, the rate of perineal hernia is lower in early follow-up, while long-term hernia occurrence appears to be similar between the different techniques. Finally, it is an easy and quick reconstruction method. Although more expensive than primary closure, the cost associated with the use of a biological mesh is at least equal, if not less, than flap reconstruction.
Core tip: Current literature regarding the use of biological mesh reconstruction after pelvic exenteration and extralevator abdominoperineal excision is scarce. However, it does suggest that the use of biological mesh has a lower short-term perineal hernia rate, but is probably not superior to other approaches with regards to perineal wound complications.
