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Sancho-Muriel J, Ocaña J, Cholewa H, Nuñez J, Muñoz P, Flor B, García JC, García-Granero E, Die J, Frasson M. Biological mesh reconstruction versus primary closure for preventing perineal morbidity after extralevator abdominoperineal excision: a multicentre retrospective study. Colorectal Dis 2020; 22:1714-1723. [PMID: 32619064 DOI: 10.1111/codi.15225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/10/2020] [Indexed: 02/08/2023]
Abstract
AIM The aim of the study was to compare the incidence of perineal hernia and the perineal wound morbidity following extralevator abdominoperineal excision (ELAPE) between two groups - primary perineal closure and reconstruction with a biological mesh. METHOD One hundred and forty-seven consecutive patients who underwent ELAPE for primary rectal cancer between January 2007 and December 2018 in two tertiary referral centres were retrospectively identified from prospective databases. Perineal closure was carried out via primary closure or with a biological mesh (porcine dermal collagen mesh). Outcome measures were perineal hernia and perineal wound morbidity (infection, dehiscence, persistent sinus and chronic pain). RESULTS A total of 139 patients were included in the study. A prophylactic mesh was used in 80 (57.5%) and primary closure was practised in 59 (42.4%) patients. The median follow-up was 30 (interquartile range 46.88) months. Thirty patients (21.6%) developed perineal hernia. No significant differences were found between prophylactic mesh and primary closure (16.3% vs 23.3%, P = 0.07). The median period between surgery and hernia diagnosis was 8 months in the primary closure group and 24 months in the mesh group (P < 0.01). Perineal wound morbidity was significantly higher in the prophylactic mesh group (55% vs 33.9%, P < 0.01). CONCLUSION In our study, the use of a biological mesh did not reduce the rate of perineal hernia, although it did delay its appearance. Perineal closure using a biological mesh may increase perineal morbidity, both acute and chronic.
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Affiliation(s)
- J Sancho-Muriel
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J Ocaña
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - H Cholewa
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J Nuñez
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - P Muñoz
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - B Flor
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J C García
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - E García-Granero
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J Die
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - M Frasson
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
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Cholewa H, Vanaclocha N, Sancho-Muriel J, Torregrosa Gallud A, García Pastor P, Bonafé Diana S, Bueno Lledó J. A challenging solution to a complex incisional hernia - a video vignette. Colorectal Dis 2020; 22:1778. [PMID: 32515112 DOI: 10.1111/codi.15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/19/2020] [Indexed: 02/08/2023]
Affiliation(s)
- H Cholewa
- Abdominal Wall Surgery Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - N Vanaclocha
- Plastic Surgery Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - J Sancho-Muriel
- Colorectal Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - A Torregrosa Gallud
- Abdominal Wall Surgery Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - P García Pastor
- Abdominal Wall Surgery Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - S Bonafé Diana
- Abdominal Wall Surgery Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - J Bueno Lledó
- Abdominal Wall Surgery Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain
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Sancho-Muriel J, Cholewa H, Primo V, García-Granero Á, Millán M, Domingo S, Valverde Navarro A, García-Granero E, Frasson M. Martius flap and sphincteroplasty as treatment for recurrent anovaginal fistula associated with anal incontinence-a video vignette. Colorectal Dis 2020; 22:1200-1201. [PMID: 32216038 DOI: 10.1111/codi.15046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 02/08/2023]
Affiliation(s)
- J Sancho-Muriel
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - H Cholewa
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - V Primo
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - Á García-Granero
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - M Millán
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - S Domingo
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - A Valverde Navarro
- Department of Anatomy and Embryology, University of Valencia, Valencia, Spain
| | - E García-Granero
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - M Frasson
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
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Parini D, Saadeh L, Zizzo M, Sancho-Muriel J, Lorenzon L, Turati L, Tutino R, Mellano A, Gallo G, Rizzo G, Morino M, Allaix M, Conti P, Scilletta R, Zuolo M, De Luca R, Frasson M, Scarpa M. Management of malignant colon and rectal polyps (T1) after endoscopic polypectomy: analysis of pathological risk factors for lymph nodes metastasis. A retrospective multicentric observational study. POST-1 (Polypectomy Or Surgery for T1). Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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García-Granero Á, Sánchez-Guillén L, Fletcher-Sanfeliu D, Sancho-Muriel J, Alvarez-Sarrado E, Pellino G, Delgado-Moraleda JJ, Sabater Ortí L, Valverde-Navarro AA, Frasson M. Surgical anatomy of D3 lymphadenectomy in right colon cancer, gastrocolic trunk of Henle and surgical trunk of Gillot - a video vignette. Colorectal Dis 2018; 20:935-936. [PMID: 30059191 DOI: 10.1111/codi.14358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 07/23/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Á García-Granero
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - L Sánchez-Guillén
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | - J Sancho-Muriel
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - E Alvarez-Sarrado
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - G Pellino
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - J J Delgado-Moraleda
- Radiodiagnosis Service, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - L Sabater Ortí
- Hepatobiliopancreatic Surgery Unit, Hospital Clínico Universitario, Valencia, Spain
| | - A A Valverde-Navarro
- Department of Human Embryology and Anatomy Department, University of Valencia, Valencia, Spain
| | - M Frasson
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
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Sancho-Muriel J, Garcia-Granero A, Fletcher-Sanfeliu D, Alvarez-Sarrado E, Sánchez-Guillén L, Pellino G, Millán M, Valverde-Navarro AA, Martinez-Soriano F, Frasson M, García-Granero E. Surgical anatomy of the deep postanal space and the re-modified Hanley procedure - a video vignette. Colorectal Dis 2018; 20:645-646. [PMID: 29665248 DOI: 10.1111/codi.14217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/19/2018] [Indexed: 01/19/2023]
Affiliation(s)
- J Sancho-Muriel
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - A Garcia-Granero
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | - E Alvarez-Sarrado
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - L Sánchez-Guillén
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - G Pellino
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M Millán
- Hospital Universitario Joan XXIII, Tarragona, Spain
| | | | - F Martinez-Soriano
- Department of Anatomy and Embryology, University of Valencia, Valencia, Spain
| | - M Frasson
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - E García-Granero
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
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Garcia-Granero A, Carreño O, Sancho-Muriel J, Alvarez-Sarrado E, Fletcher-Sanfeliu D, Sánchez-Guillén L, Pellino G, García-Amador C, Pamies J, Valverde-Navarro AA, Martinez-Soriano F, Frasson M. Anatomical strategy for complete laparoscopic mesocolic excision for splenic flexure colonic cancer - a video vignette. Colorectal Dis 2018; 20:555-556. [PMID: 29578304 DOI: 10.1111/codi.14111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/12/2018] [Indexed: 02/08/2023]
Affiliation(s)
- A Garcia-Granero
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - O Carreño
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - J Sancho-Muriel
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - E Alvarez-Sarrado
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - D Fletcher-Sanfeliu
- Department of Cardiovascular Surgery, Hospital Universitario Son Espases, Mallorca, Spain
| | - L Sánchez-Guillén
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - G Pellino
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - C García-Amador
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - J Pamies
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | | | - F Martinez-Soriano
- Department of Anatomy and Embryology, University of Valencia, Valencia, Spain
| | - M Frasson
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
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