title: Extralevator abdominoperineal excision for rectal cancer with biological mesh for pelvic floor reconstruction.
abstract: OBJECTIVE
  To share our experience of extra-levator abdominoperineal excision (ELAPE) for low rectal cancer, focusing on perineal repair with biological mesh.
  
  
  METHODS
  We retrospectively analyzed medical records of all patients with low rectal cancer who underwent the ELAPE procedure using biological mesh for perineal repair at the Gastrointestinal Surgery of Nanjing Drum Power Hospital between January 2013 and September 2015. All patients were closely followed up to now.
  
  
  RESULTS
  A total of 17 patients underwent ELAPE for low rectal cancer was screened. Of these, 15 patients had primary rectal cancer, 1 had local recurrent rectal cancer, and 1 had malignant melanoma. All patients underwent ELAPE successfully without intestinal perforation and got stage I healing in perineum wound without incision infection, dehiscence, cystocele perinealis, urethral dysfunction or intestinal obstruction. Perineum wound hematoma developed in just one patient and had successful percutaneous drainage in one week. During the follow-up, there was no recurrence, perineal hernia, sexual dysfunction, urinary retention, or bowel obstruction. Two patients described slight pain in the sacrococcygeal region without special handling.
  
  
  CONCLUSIONS
  ELAPE is applicable to low rectal cancer. Biological mesh reconstruction of perineal defect seems to be safe and effective, with high patient compliance.
authors.affiliation: Department of general surgery, Nanjing Drum Tower Hospital, the affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, P. R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ge
authors.affiliation: Department of general surgery, Nanjing Drum Tower Hospital, the affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, P. R. China.
authors.forename: Song-Song
authors.initials: SS
authors.lastname: Jiang
authors.affiliation: Department of general surgery, Nanjing Drum Tower Hospital, the affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, P. R. China.
authors.forename: Wang
authors.initials: W
authors.lastname: Qi
authors.affiliation: Department of general surgery, Nanjing Drum Tower Hospital, the affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, P. R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of general surgery, Nanjing Drum Tower Hospital, the affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, P. R. China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Zheng
authors.affiliation: Department of general surgery, Nanjing Drum Tower Hospital, the affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, P. R. China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D017773:Pelvic Floor / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
keywords: ELAPE; biological mesh; extra-levator abdominoperineal excision; low rectal cancer; pelvic reconstruction