TY - JOUR
T1 - A comparative multicentre study evaluating gluteal turnover flap for wound closure after abdominoperineal resection for rectal cancer
AU - Sharabiany, S.
AU - van Dam, J. J. W.
AU - Sparenberg, S.
AU - Blok, R. D.
AU - Singh, B.
AU - Chaudhri, S.
AU - Runau, F.
AU - van Geloven, A. A. W.
AU - van de Ven, A. W. H.
AU - Lapid, O.
AU - Hompes, R.
AU - Tanis, P. J.
AU - Musters, G. D.
N1 - Funding Information: The authors would like to thank S. van Dieren, Amsterdam UMC, for her help in statistical analysis. Publisher Copyright: © 2021, The Author(s).
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: The aim of this study was to compare perineal wound healing between gluteal turnover flap and primary closure in patients undergoing abdominoperineal resection (APR) for rectal cancer. Methods: Patients who underwent APR for primary or recurrent rectal cancer with gluteal turnover flap in two university hospitals (2016–2021) were compared to a multicentre cohort of primary closure (2000–2017). The primary endpoint was uncomplicated perineal wound healing within 30 days. Secondary endpoints were long-term wound healing, related re-interventions, and perineal herniation. The perineal hernia rate was assessed using Kaplan Meier analysis. Results: Twenty–five patients had a gluteal turnover flap and 194 had primary closure. The uncomplicated perineal wound-healing rate within 30 days was 68% (17/25) after gluteal turnover flap versus 64% (124/194) after primary closure, OR 2.246; 95% CI 0.734–6.876; p = 0.156 in multivariable analysis. No major wound complications requiring surgical re-intervention occurred after flap closure. Eighteen patients with gluteal turnover flap completed 12-month follow-up, and none of them had chronic perineal sinus, compared to 6% (11/173) after primary closure (p = 0.604). The symptomatic 18-month perineal hernia rate after flap closure was 0%, compared to 9% after primary closure (p = 0.184). Conclusions: The uncomplicated perineal wound-healing rate after the gluteal turnover flap and primary closure after APR is similar, and no chronic perineal sinus or perineal hernia occurred after flap closure. Future studies have to confirm potential benefits of the gluteal turnover flap.
AB - Background: The aim of this study was to compare perineal wound healing between gluteal turnover flap and primary closure in patients undergoing abdominoperineal resection (APR) for rectal cancer. Methods: Patients who underwent APR for primary or recurrent rectal cancer with gluteal turnover flap in two university hospitals (2016–2021) were compared to a multicentre cohort of primary closure (2000–2017). The primary endpoint was uncomplicated perineal wound healing within 30 days. Secondary endpoints were long-term wound healing, related re-interventions, and perineal herniation. The perineal hernia rate was assessed using Kaplan Meier analysis. Results: Twenty–five patients had a gluteal turnover flap and 194 had primary closure. The uncomplicated perineal wound-healing rate within 30 days was 68% (17/25) after gluteal turnover flap versus 64% (124/194) after primary closure, OR 2.246; 95% CI 0.734–6.876; p = 0.156 in multivariable analysis. No major wound complications requiring surgical re-intervention occurred after flap closure. Eighteen patients with gluteal turnover flap completed 12-month follow-up, and none of them had chronic perineal sinus, compared to 6% (11/173) after primary closure (p = 0.604). The symptomatic 18-month perineal hernia rate after flap closure was 0%, compared to 9% after primary closure (p = 0.184). Conclusions: The uncomplicated perineal wound-healing rate after the gluteal turnover flap and primary closure after APR is similar, and no chronic perineal sinus or perineal hernia occurred after flap closure. Future studies have to confirm potential benefits of the gluteal turnover flap.
KW - Abdominoperineal resection
KW - Perineal wound healing
KW - Rectal cancer
KW - Wound closure
UR - http://www.scopus.com/inward/record.url?scp=85114329936&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10151-021-02496-7
DO - https://doi.org/10.1007/s10151-021-02496-7
M3 - Article
C2 - 34263363
SN - 1123-6337
VL - 25
SP - 1123
EP - 1132
JO - Techniques in coloproctology
JF - Techniques in coloproctology
IS - 10
ER -