Moreno-Sanz Carlos, Manzanera-Díaz Marina, Clerveus Mikael, Cortina-Oliva F Javier, de Pedro-Conal Julián, Picazo-Yeste Joaquín
Servicio de Cirugía, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
Cir Esp. 2011 Feb;89(2):77-81. doi: 10.1016/j.ciresp.2010.10.004. Epub 2010 Dec 21.
Despite the advances in the treatment of cancer of the rectum and the expansion of the multimodal therapeutic technique, abdominoperineal resection (APR) still needs to be performed as radical treatment in 20-30% of cases. APR of the rectum involves a significant morbidity, including intestinal obstruction and wound complications, with radiotherapy-induced enteritis being able to develop in 15% of cases subjected to post-operative radiotherapy. Furthermore, with the aim of improving local oncology results, an extended APR is recommended; a technique that requires a perineal reconstruction technique that allows a tension free closure in a previously radiated tissue and may prevent perineal hernias developing. The objective of this article is to review pelvic and perineal repair methods after APR due to cancer, with special attention to the new prosthetic repair techniques.
尽管直肠癌治疗取得了进展,多模式治疗技术也有所扩展,但腹会阴联合切除术(APR)在20%-30%的病例中仍需作为根治性治疗手段施行。直肠APR会引发包括肠梗阻和伤口并发症在内的显著发病率,术后接受放疗的病例中有15%会发生放射性肠炎。此外,为提高局部肿瘤学疗效,推荐施行扩大根治性APR;该技术需要一种会阴重建技术,以便在先前接受过放疗的组织中实现无张力缝合,并可防止会阴疝的发生。本文旨在综述因癌症行APR术后的盆腔和会阴修复方法,尤其关注新型假体修复技术。