Total perineal reconstruction after abdominoperineal excision for rectal cancer: long‐term results of dynamic graciloplasty with Malone appendicostomy

Orabi, Nora Abbes; Vanwymersch, T.; Paterson, Hugh; Mauel, E.; Jamart, Jacques; Crispin, Brigitte; Kartheuser, Alex

doi:10.1111/j.1463-1318.2009.02168.x

Cited by 12 publications

(1 citation statement)

References 28 publications

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“…Conjoint analysis is a quantitative method originally developed in applied sciences which can be used to evaluate clinical decision-making in healthcare. 10 – 17 Full control of potentially confounding factors can be achieved by having each participant evaluate the same clinical factors with according levels. As such, conjoint analysis is considered as a good method to effectively analyze decision-making in clinical medicine.…”

Section: Methodsmentioning

confidence: 99%

Chronic anemia due to gastrointestinal bleeding: when do gastroenterologists transfuse?

Grooteman

Geenen

Kievit

et al. 2017

United European Gastroenterology Journal

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BackgroundThe hypothesis is that decision-making for transfusion varies considerably among gastroenterologists. The aim is to identify preferences and predictors of transfusion decision-making in chronic anemia.Study design and methodsBetween February and April of 2015, a computerized adaptive choice-based conjoint survey was administered to gastroenterologists in the Netherlands. The survey included seven patient attributes: hemoglobin levels, hemoglobin stability, age, iron indices, the presence of anemia-related symptoms, cardiovascular comorbidities, and the number of transfusions in the past half year. Predictors of transfusion preferences were assessed by multivariable regression.Results113 gastroenterologists completed the survey (response rate = 29%; mean age = 47 years; 24% women). Absolute hemoglobin level was the most important incentive of transfusion, accounting for 42% of decision-making, followed by age (15%), hemoglobin stability (12%), anemia-related symptoms (10%), and cardiovascular comorbidities (10%). A hemoglobin level >9.6 g/dL is an inflection point, where gastroenterologists would not prescribe transfusions. Age of the patient is more important in the decision-making process to younger gastroenterologists (OR −2.9, 95% CI −5.3 to −0.5).ConclusionAbsolute hemoglobin level is the most important factor to transfusion decision-making. This is contradictory to transfusion guidelines for chronic anemia which address the importance of symptoms.

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Section: Methodsmentioning

confidence: 99%

Chronic anemia due to gastrointestinal bleeding: when do gastroenterologists transfuse?

Grooteman

Geenen

Kievit

et al. 2017

United European Gastroenterology Journal

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Functional outcomes over time following perineal pseudocontinent colostomy reconstruction after abdominoperineal resection for ultralow rectal adenocarcinoma

Souadka

Majbar

Essangri

et al. 2020

Journal of Surgical Oncology

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Background and ObjectivesPseudocontinent‐perineal colostomy (PCPC) following abdominoperineal resection (APR) is a promising technique associated with good quality of life. This study evaluates over time the functional results after PCPC using the Kirwan score.MethodsAll PCPC patients operated on from January 2001 to January 2016 were followed with their functional results assessed at four checkpoints. A/B Kirwan scores and a 48 to 72 hours colonic irrigation rhythm were considered “good” and “convenient” and their overall variations over time were assessed by means of Cochran's Q test corrected by Bonferroni post hoc test.ResultsFifty‐seven eligible patients were included in the study with 33 (58%) women. We noted a significant difference in both Kirwan score and colic irrigation rhythm during the four checkpoints in follow‐up with Q(1) = 85.01 and Q(2) = 69. 86. By the fourth checkpoint, 86% of patients had a Kirwan score of A/B. Concerning the rhythm of colonic irrigation, there was a significant improvement between 6 months and other checkpoints. In the second year, 63% of patients reduced their colonic irrigation rhythm.ConclusionsThe functional results of PCPC after APR improve and stabilize from 6 months to 1 year after surgery thus making PCPC a good alternative that surgeons can present to their patients.

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Major Resections in Rectal Cancer

Vîlcea

Mirea

2020

Multidisciplinary Treatment of Colorectal Cancer

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Total perineal reconstruction after abdominoperineal excision for rectal cancer: long‐term results of dynamic graciloplasty with Malone appendicostomy

Abstract: In carefully selected patients who want to avoid definitive abdominal colostomy after APR for rectal cancer, reconstruction involving MA and DG after APR for low rectal cancer is followed by good long-term function and QoL.

Cited by 12 publications

References 28 publications

Chronic anemia due to gastrointestinal bleeding: when do gastroenterologists transfuse?

Chronic anemia due to gastrointestinal bleeding: when do gastroenterologists transfuse?

Functional outcomes over time following perineal pseudocontinent colostomy reconstruction after abdominoperineal resection for ultralow rectal adenocarcinoma

Major Resections in Rectal Cancer

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