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Impact of perineal pseudocontinent colostomy on perineal wound healing after abdominoperineal resection. 2012

Frédéric Dumont, and Amine Souadka, and Diane Goéré, and Philippe Lasser, and Dominique Elias
Department of Surgery, Institut Gustave Roussy Cancer Center, Villejuif, France. frederic.dumont@igr.fr

BACKGROUND Abdominoperineal resections (APR) for anorectal tumors are associated with a high rate of perineal wound complications. The aim of this study was to evaluate the impact of pseudocontinent perineal colostomy (PPC) following APR on perineal wound healing. METHODS All patients undergoing APR between 2000 and 2009 were retrospectively reviewed. Perineal wound healing was compared between patients with PPC and those with perineal closure alone. RESULTS APR was performed in 132 patients, including 31 with PPC and 101 with no PPC. Risk factors such as radiotherapy, smoking, diabetes mellitus, and obesity were not different between the two groups. The PPC group had significantly fewer cases of omentoplasty and adenocarcinoma histology. The overall perineal complication rate, perineal infection, or wound dehiscence was similar in the two groups, but the perineal healing rate at 6 and 12 weeks was significantly increased in the PPC group than in the non-PPC group (70.9% vs. 50%, P = 0.04, at 6 weeks; 90.3% vs. 73%, P = 0.04, at 12 weeks). CONCLUSIONS PPC accelerates perineal wound healing after APR without decreasing the overall perineal complication rate.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010502 Perineum The body region lying between the genital area and the ANUS on the surface of the trunk, and to the shallow compartment lying deep to this area that is inferior to the PELVIC DIAPHRAGM. The surface area is between the VULVA and the anus in the female, and between the SCROTUM and the anus in the male. Perineums
D012004 Rectal Neoplasms Tumors or cancer of the RECTUM. Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D003125 Colostomy The surgical construction of an opening between the colon and the surface of the body. Colostomies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000005 Abdomen That portion of the body that lies between the THORAX and the PELVIS. Abdomens
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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