title: [Perineal reconstruction after extralevator abdominoperineal excision(ELAPE) for carcinoma at the lower rectum].
abstract: Extralevator abdominoperineal excision (ELAPE) has been described to improve the outcomes of advanced low rectal cancer, probably because of more pelvic dissection and less positive circumferential resection margin (CRM). Recent improvements of ELAPE have focused on the reconstruction of the large pelvic defect. Different approaches have been focused on the reconstruction including primary closure, uterus retroversion, omentoplasty, myocutaneous flaps, and biological mesh. The optimal method is still controversial. Recent reviews showed that the perineal wound complications of biological mesh reconstruction were comparable to those of myocutaneous flaps. Moreover reviews suggested the use of biologic materials to close the perineal defect because it offers a significant cost saving mostly attributable to reduction in hospital length of stay. The combination of different techniques may be the best way to reconstruct the pelvic defect following ELAPE.
authors: Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China. wang3zj@sohu.com.
authors: Zhenjun
authors: Z
authors: Wang
authors: Jiagang
authors: J
authors: Han
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D017773:Pelvic Floor / Q000601:surgery*; D010502:Perineum / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery