Article information
Abstract
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.
Keywords:
Abdominoperineal resection
Rectal cancer
Pelvis
Pelvic floor
Perineum
Reconstruction
Resumen
A pesar de los avances en el tratamiento del cáncer de recto y la expansión del abordaje terapéutico multimodal, todavía es necesaria la realización de una amputación abdominoperineal (AAP) como tratamiento radical en el 20–30% de los casos.
La AAP del recto está gravada con una importante morbilidad, destacando la obstrucción intestinal y las complicaciones de la herida, pudiendo desarrollarse una enteritis rádica en el 15% de los casos sometidos a radioterapia postoperatoria. Además, con el fin de mejorar los resultados oncológicos a nivel local, se recomienda la realización de una AAP ampliada, técnica que precisa de un procedimiento de reconstrucción perineal que permita un cierre sin tensión en un tejido previamente radiado y prevenga el desarrollo de hernias perineales.
El objetivo de este trabajo es revisar los métodos de reparación pélvica y perineal tras la AAP por cáncer, con especial atención a las nuevas técnicas de reparación protésica.
Palabras clave:
Resección abdominoperineal
Cáncer de recto
Pelvis
Suelo pélvico
Periné
Reconstrucción
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