Alleviating perineal tightness following abdominoperineal rectal resection

Abstract

Background Perineal wound complications after abdominoperineal rectal resection (APR) are both frequent and clinically relevant for their impact on length of hospitalization, overall costs, patients' quality of life and oncological results. A close follow-up of these patients even when primary healing was complete revealed that most of them still had a sense of perineal tightness and discomfort during daily activities such as walking, sitting, and riding. Aim of the work The aim of this work was to study the use of a simple perineal L-shaped flap in alleviating the sense of perineal tightness and discomfort following APR, as well as for improving wound-healing rates. Patients and methods The study included 28 patients indicated for APR. After APR was carried out (conventional or extralevator), an L-shaped fasciocutaneous flap was designed on one side of the perineum and was used to close the perineal wound. Wound complications and sense of perineal tightness were recorded. Results An overall 75% of perineal wounds following APR healed without complications. The remaining had minor complications. A total of 23 patients (82.1%) stated that they had no sense of perineal tightness. Conclusion The simple L-shaped fasciocutaneous flap not only improves perineal wound healing but also improves the patients' quality of life by alleviating the sense of tightness, especially during sitting.