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Surgical Endoscopy

Published in:

01-06-2021

The impact of laparoscopic technique on the rate of perineal hernia after abdominoperineal resection of the rectum

Authors: Anna J. Black, Ahmer Karimuddin, Manoj Raval, Terry Phang, Carl J. Brown

Published in: Surgical Endoscopy | Issue 6/2021

Abstract

Aim

To determine the impact of surgical technique on the incidence of perineal hernia after abdominoperineal resection (APR).

Methods

A retrospective analysis was performed on patients who underwent APR between May 2007 and March 2018 at our institution using our prospectively maintained Colorectal Cancer Database. Demographic and clinical parameters were compared between the open APR (OAPR) and laparoscopic APR (LAPR) groups using Student’s t test, chi-squared, or Fisher’s exact test. Putative risk factors were then analyzed using a Cox proportional hazard model with perineal hernia as the outcome.

Results

The study included 261 patients (191 OAPR and 70 LAPR). Intraoperative blood loss (596.0 ± 633.4 vs. 307.0 ± 307.2 mL, p < 0.001), duration of OR (249.6 ± 115.6 vs. 212.6 ± 75.1 min, p = 0.004), and length of stay (15.6 ± 18.0 vs. 10.4 ± 12.6 days, p = 0.031) were all greater for OAPR than LAPR patients, but wound complications other than hernia did not differ significantly. Perineal hernia was observed in 2.1% of OAPR and 12.9% of LAPR patients. In multivariable analysis, significant risk factors for perineal hernia were age, laparoscopic technique, and closure of the perineal wound with myocutaneous flap (HR 1.08, 11.13, and 31.51, respectively, all p < 0.05).

Conclusions

LAPR, although associated with less blood loss and shorter length of hospital stay than OAPR, was a significant risk factor for perineal hernia.

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Title: The impact of laparoscopic technique on the rate of perineal hernia after abdominoperineal resection of the rectum
Authors: Anna J. Black
Ahmer Karimuddin
Manoj Raval
Terry Phang
Carl J. Brown
Publication date: 01-06-2021
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 6/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07746-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact of laparoscopic technique on the rate of perineal hernia after abdominoperineal resection of the rectum

Abstract

Aim

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Methods

Results

Conclusions

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