Salvage Abdominoperineal Resection After Failure of Conservative Treatment in Anal Epidermoid Cancer

Ghouti, Laurent; Houvenaeghel, Gilles; Moutardier, Vincent; Giovannini, Marc; Magnin, Valérie; Lelong, Bernard; Bardou, Valérie‐Jeanne; Delpero, Jean‐Robert

doi:10.1007/s10350-004-0746-1

Cited by 67 publications

(59 citation statements)

References 29 publications

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“…For example, Haas et al 24 described this technique in 26 patients and showed poor graft take in irradiated tissues in 9 cases (i.e., 35 percent). In the series reported by Mullen et al 18 and Ghouti et al 25 the incidence of perineal complications after primary flap reconstruction were 35 percent (11 of 31 patients) and 36 percent (13 of 36) respectively. The use of this type of muscle flap considerably prolongs the operating time and weakens the abdominal musculature.…”

Section: Discussionmentioning

confidence: 94%

Abdominoperineal Resection for Anal Cancer

Mariani

Ghanneme²,

Rochefordière³

et al. 2008

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 94%

Abdominoperineal Resection for Anal Cancer

Mariani

Ghanneme²,

Rochefordière³

et al. 2008

Diseases of the Colon &Amp; Rectum

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“…This is similar to the reported rate of 2% by Sunesen 12 and the <5% flap necrosis reported previously in the literature. 14 We believe that if the origin is divided, then the flap does need a suture to support it to the bladder or pelvic side wall to minimise traction on the pedicle. We have modified our technique to include this suture since we had the flap failure.…”

mentioning

confidence: 99%

Rectus abdominis myocutaneous flaps for perineal reconstruction: modifications to the technique based on a large single-centre experience

McMenamin

Clements

Edwards

et al. 2011

annals

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INTRODUCTION Perineal wound breakdown with delayed wound healing represents a significant cause of morbidity following surgery and radiotherapy to the perineum. The rectus abdominis myocutaneous (RAM) flap has been used increasingly to reconstruct the perineum with good effect. We describe our six-year experience of reconstruction of the perineum with the RAM flap and share some surgical adjuncts we believe are useful. METHODS We conducted a retrospective case note review of all patients who underwent a reconstruction of the perineum using the RAM flap between August 2003 and October 2009. Indications for the flap, complication rates and outcomes were all observed. RESULTS We conducted 16 RAM flap procedures, 15 of which (94%) were primary repairs and 1 (6%) a secondary repair. Three (19%) developed donor site hernias, two (12.5%) developed minor perineal wound infections, eight (50%) developed minor perineal wound breakdown and in one (6%) flap failure was observed. No perineal hernias were observed. There were no surgical mortalities. CONCLUSIONS The RAM flap has a high success rate and an acceptable morbidity rate and is a useful tool in the reconstruction of complex perineal wounds. Modifications to the standard surgical technique may reduce complications and improve the versatility of this flap.

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“…Abdominoperineal resection in patients having received high and curative doses of RT is associated with high complication rates (2,29). Prediction of poor response, i.e.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of Cyclin A in epidermoid anal cancer

Nilsson

Lenander²,

Rubio³

et al. 2006

Oncol Rep

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Abstract. Ultimately aiming at a more individualized therapeutic approach in epidermoid anal cancer, this study explored the prognostic and predictive impact of a set of tumour markers. From a population-based cohort of 276 patients with epidermoid anal cancer, treated according to prospective protocols, 215 pre-treatment biopsies were investigated using immunohistochemistry. The expression of p53, p21, Cyclin A and CD31 was measured semiquantitatively. The expression rate was classified as high when immunostaining was seen in >5% of the tumour cells for p53 and p21, >20% in Cyclin A and, above median vessel count for CD31. Marker expression was correlated to survival and treatment response. A high Cyclin A expression correlated significantly with improved overall (77% vs 59%, p=0.005) and tumour-specific (81% vs 64 %, p=0.009) survival at 5 years. Also, the locoregional failure rate was significantly lower in patients with a high Cyclin A expression (12% vs 24%, p<0.05). In a multivariate Cox analysis Cyclin A was an independent prognostic factor. A low p21 expression correlated with a reduced rate of locoregional failure (14% vs 27%, p<0.05) but no impact on survival was found. For p53 and CD31 no significant correlations were obtained. Cyclin A may be an indicator of radiosensitivity and a valuable prognostic marker in epidermoid anal cancer.

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Salvage Abdominoperineal Resection After Failure of Conservative Treatment in Anal Epidermoid Cancer

Abstract: Despite high incidence of perineal morbidity, salvage abdominoperineal resection for epidermoid carcinomas of the anal canal has a high long-term survival rate.

Cited by 67 publications

References 29 publications

Abdominoperineal Resection for Anal Cancer

Abdominoperineal Resection for Anal Cancer

Rectus abdominis myocutaneous flaps for perineal reconstruction: modifications to the technique based on a large single-centre experience

Prognostic significance of Cyclin A in epidermoid anal cancer

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