Rongen MJ, Dekker FA, Geerdes BP, Heineman E, Baeten CG. Secondary coloperineal pull-through and double dynamic graciloplasty after Miles resection--feasible, but with a high morbidity.
Dis Colon Rectum 1999;
42:776-80; discussion 781. [PMID:
10378602 DOI:
10.1007/bf02236934]
[Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE
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.
CONCLUSION
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.
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