title: Secondary coloperineal pull-through and double dynamic graciloplasty after Miles resection--feasible, but with a high morbidity.
abstract: OBJECTIVE
  Until recently, patients who underwent abdominoperineal resections had to cope with a colostomy for the rest of their lives. For some of these patients this colostomy was a terrible burden, physically and mentally. Publications about abdominoperineal pull-through and double dynamic graciloplasty immediately after a Miles resection showed good results. The purpose of this study was to investigate the procedure as a secondary approach after abdominoperineal resections.
  
  
  METHODS
  In this study seven patients were evaluated. All had had an abdominoperineal resection and proved to have unbearable problems with their stoma. All had a secondary pull-through and double dynamic graciloplasty, a mean of 8.5 (range, 1.1-34.8) years after the Miles resection.
  
  
  RESULTS
  In five patients continence was regained; two were reversed to colostomy because of several complications. Patients who had a successful outcome also suffered from numerous complications, with a total mean hospital stay of 73.8 (range, 27-167) days, a mean of 3.1 (range, 1-6) additional operations, and 1.8 (range, 0-4) readmissions.
  
  
  CONCLUSIONS
  Secondary anorectal reconstruction after abdominoperineal resection is a feasible option, but with a high morbidity. Because of this the procedure was stopped at the beginning of 1997.
authors.affiliation: Department of Surgery, University Hospital Maastricht, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Rongen
authors.forename: F A
authors.initials: FA
authors.lastname: Dekker
authors.forename: B P
authors.initials: BP
authors.lastname: Geerdes
authors.forename: E
authors.initials: E
authors.lastname: Heineman
authors.forename: C G
authors.initials: CG
authors.lastname: Baeten
mesh_terms: D003106:Colon / Q000601:surgery*; D003125:Colostomy; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation