Current status and strategies of pelvic floor peritoneum reconstruction in radical resection for low rectal cancer

doi:10.3877/cma.j.issn.1674-0793.2023.04.018

Abstract

Abstract:

Currently, the treatment of rectal malignancies mainly include laparoscopic-assisted low anterior resection and combined abdominoperineal resection. Although the safety of surgery has been improved with the continuous refinement of rectal membrane anatomy, both procedures inevitably destroy the integrity of the pelvic floor peritoneum, followed by complications such as perineal infection, perineal hernia, intestinal obstruction, radiation enteritis , and urinary dysfunction. A number of studies have found that the occurrence of complications may be correlated with pelvic floor peritoneal reconstruction, but the need for intraoperative pelvic floor peritoneum reconstruction is still controversial, especially for combined abdominoperineal resection. The purpose of this article is to describe the progress of research on pelvic floor peritoneal reconstruction strategies, modalities and complications of radical rectal cancer surgery.

Key words: Rectal neoplasms, Pelvic floor peritoneum reconstruction, Methods of reconstruction, Complications

Kang Yang, Dechen Wang, Zijie Yang, Mingbin Gui, Zengqiang Yang, Lianping Qu, Feng Gao. Current status and strategies of pelvic floor peritoneum reconstruction in radical resection for low rectal cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(04): 316-320.

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References 42

[1]	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[2]	Johal KS, Mishra A, Alkizwini E, et al. Immediate vaginal and perineal reconstruction after abdominoperineal excision using the Inferior Gluteal Artery Perforator Flap (V-IGAP)[J]. J Plast Reconstr Aesthet Surg, 2022, 75(1): 137-144.
[3]	刘乃青, 孙淑香, 周忠晋, 等. 腹膜外造口和盆底腹膜重建预防腹腔镜下Miles术后造口旁疝和盆底粘连梗阻[J]. 中华普通外科杂志, 2014, 29(10): 804-805.
[4]	李明东, 谢红强, 陶涛, 等.结直肠癌患者术后肠梗阻发生风险列线图预测模型的构建及评估[J/CD]. 中华消化病与影像杂志(电子版), 2021,11(4): 158-163.
[5]	Zhang H, Li G, Cao K, et al. Long-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer[J]. BMC Surg, 2022, 22(1): 242.
[6]	Zaharie F, Ciorogar G, Zaharie R, et al. Laparoscopic rectal resection versus conventional open approach for rectal cancer - a 4-year experience of a single center[J]. J BUON, 2015, 20(6): 1447-1455.
[7]	Landi F, Vallribera F, Rivera JP, et al. Morbidity after laparoscopic and open rectal cancer surgery: A comparative analysis of morbidity in octogenarians and younger patients[J]. Colorectal Dis, 2016, 18(5): 459-467.
[8]	Hida K, Okamura R, Sakai Y, et al. Open versus laparoscopic surgery for advanced low rectal cancer: A large, multicenter, propensity score matched cohort study in Japan[J]. Ann Surg, 2018, 268(2): 318-324.
[9]	Hajibandeh S, Hajibandeh S, Eltair M, et al. Meta-analysis of transanal total mesorectal excision versus laparoscopic total mesorectal excision in management of rectal cancer[J]. Int J Colorectal Dis, 2020, 35(4): 575-593.
[10]	池畔, 王枭杰. 膜解剖——推动精准腔镜与机器人结直肠外科的动力[J]. 中华胃肠外科杂志, 2019, 22(5): 406-412.
[11]	Jung M, Morel P, Buehler L, et al. Robotic general surgery: current practice, evidence, and perspective[J]. Langenbecks Arch Surg, 2015, 400(3): 283-292.
[12]	Wang S, Meng Q, Gao J, et al. The application of extraperitoneal ostomy combined with pelvic peritoneal reconstruction in laparoscopic abdominoperineal resection for rectal cancer[J]. Gastroenterol Res Pract, 2019, 2019: 3015958.
[13]	Cura Pales CG, An S, Cruz JP, et al. Postoperative bowel function after anal sphincter-preserving rectal cancer surgery: risks factors, diagnostic modalities, and management[J]. Ann Coloproctol, 2019, 35(4): 160-166.
[14]	Ji L, Li S, Xin C, et al. Pelvic floor peritoneum reconstruction is a protective factor for defecation dysfunction after laparoscopic anterior resection in patients with middle and low rectal cancer[J]. Surg Today, 2022, 52(9): 1320-1328.
[15]	高林丰, 陈栋林, 陈柏宇, 等. 盆底腹膜重建对腹腔镜直肠癌低位前切除术后短期并发症的影响[J]. 中华胃肠外科杂志, 2021, 24(12): 1079-1085.
[16]	Wang ZK, Xu J, Shang CC, et al. Clinical significance of pelvic peritonization in laparoscopic dixon surgery[J]. Chin Med J (Engl), 2018, 131(3): 289-294.
[17]	Farinella E, Viganò L, Bertolino F, et al. Combination of omentoplasty, trans-abdominal biological mesh, and vacuum-assisted closure system for complex pelvic floor reconstruction. An alternative to current standards?[J]. Int J Colorectal Dis, 2013, 28(12): 1729-1730.
[18]	Peirce C, Martin S. Management of the perineal defect after abdominoperineal excision[J]. Clin Colon Rectal Surg, 2016, 29(2): 160-167.
[19]	Shen Y, Yang T, Deng X, et al. Pelvic peritoneum reconstruction using the bladder peritoneum flap in laparoscopic extralevator abdominoperineal excision: A multi-center, prospective single-arm cohort study (IDEAL Phase 2A)[J]. Medicine (Baltimore), 2020, 99(25): e20712.
[20]	Hellinga J, Khoe PC, van Etten B, et al. Fasciocutaneous lotus petal flap for perineal wound reconstruction after extralevator abdominoperineal excision: application for reconstruction of the pelvic floor and creation of a neovagina[J]. Ann Surg Oncol, 2016, 23(12): 4073-4079.
[21]	Keller DS, Ibarra S, Flores-Gonzalez JR, et al. Outcomes for single-incision laparoscopic colectomy surgery in obese patients: A case-matched study[J]. Surg Endosc, 2016, 30(2): 739-744.
[22]	Yan X, Su H, Zhang S, et al. Pelvic peritoneum closure reduces postoperative complications of laparoscopic abdominoperineal resection: 6-year experience in single center[J]. Surg Endosc, 2021, 35(1): 406-414.
[23]	刘洪洲, 李永胜, 陈俊生, 等. 腹腔镜Miles术重建盆底腹膜14例技巧体会[J/CD]. 中华普通外科学文献(电子版), 2014, 8(2): 135-136.
[24]	Devulapalli C, Jia Wei AT, DiBiagio JR, et al. Primary versus flap closure of perineal defects following oncologic resection: A systematic review and meta-analysis[J]. Plast Reconstr Surg, 2016, 137(5): 1602-1613.
[25]	Blok RD, Hagemans J, Klaver C, et al. A systematic review and meta-analysis on omentoplasty for the management of abdominoperineal defects in patients treated for cancer[J]. Ann Surg, 2020, 271(4): 654-662.
[26]	Zhang C, Yang X, Bi H. Application of depithelized gracilis adipofascial flap for pelvic floor reconstruction after pelvic exenteration[J]. BMC Surg, 2022, 22(1): 304.
[27]	Abdou AH, Li L, Khatib-Chahidi K, et al. Free latissimus dorsi myocutaneous flap for pelvic floor reconstruction following pelvic exenteration[J]. Int J Colorectal Dis, 2016, 31(2): 385-391.
[28]	Cibula D, Zikan M, Fischerova D, et al. Pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after pelvic exenterations[J]. Gynecol Oncol, 2017, 144(3): 558-563.
[29]	Zhang J, Wang GY, Xiao YP, et al. The biomechanical behavior and host response to porcine-derived small intestine submucosa, pericardium and dermal matrix acellular grafts in a rat abdominal defect model[J]. Biomaterials, 2011, 32(29): 7086-7095.
[30]	Fujii S, Tsukamoto M, Shimada R, et al. Absorptive anti-adhesion barrier for the prevention of bowel obstruction after laparoscopic colorectal cancer surgery[J]. J Anus Rectum Colon, 2018, 2(1): 1-8.
[31]	Watanabe J, Ishida F, Ishida H, et al. A prospective multi-center registry concerning the clinical performance of laparoscopic colorectal surgery using an absorbable adhesion barrier (INTERCEED^®) made of oxidized regenerated cellulose[J]. Surg Today, 2019, 49(10): 877-884.
[32]	Yasukawa D, Hori T, Kadokawa Y, et al. Trans-perineal minimally invasive surgery during laparoscopic abdominoperineal resection for low rectal cancer[J]. Surg Endosc, 2019, 33(2): 437-447.
[33]	Musters GD, Buskens CJ, Bemelman WA, et al. Perineal wound healing after abdominoperineal resection for rectal cancer: A systematic review and meta-analysis[J]. Dis Colon Rectum, 2014, 57(9): 1129-1139.
[34]	Liu C, Li X, Wang Q. Postoperative complications observed with robotic versus laparoscopic surgery for the treatment of rectal cancer: An updated meta-analysis of recently published studies[J]. Medicine (Baltimore), 2021, 100(36): e27158.
[35]	Hain E, Maggiori L, Mongin C, et al. Risk factors for prolonged postoperative ileus after laparoscopic sphincter-saving total mesorectal excision for rectal cancer: An analysis of 428 consecutive patients[J]. Surg Endosc, 2018, 32(1): 337-344.
[36]	Goedhart-de Haan AM, Langenhoff BS, Petersen D, et al. Laparoscopic repair of perineal hernia after abdominoperineal excision[J]. Hernia, 2016, 20(5): 741-746.
[37]	Blok RD, Musters GD, Borstlap W, et al. Snapshot study on the value of omentoplasty in abdominoperineal resection with primary perineal closure for rectal cancer[J]. Ann Surg Oncol, 2018, 25(3): 729-736.
[38]	Balla A, Batista Rodríguez G, Buonomo N, et al. Perineal hernia repair after abdominoperineal excision or extralevator abdominoperineal excision: A systematic review of the literature[J]. Tech Coloproctol, 2017, 21(5): 329-336.
[39]	Melich G, Lim DR, Hur H, et al. Prevention of perineal hernia after laparoscopic and robotic abdominoperineal resection: review with illustrative case series of internal hernia through pelvic mesh[J]. Can J Surg, 2016, 59(1): 54-58.
[40]	Luo W, Lu T, Xu Z, et al. A novel technique with ileal mesentery to reconstruct the pelvic peritoneum after pelvic dissection with end colostomy for rectal cancer[J]. Dis Colon Rectum, 2022, 65(9): e910-e913.
[41]	Sharabiany S, Kreisel SI, Strijk GJ, et al. Exploring the impact of urogenital organ displacement after abdominoperineal resection on urinary and sexual function[J]. Int J Colorectal Dis, 2022, 37(10): 2125-2136.
[42]	Yu HC, Peng H, He XS, et al. Comparison of short- and long-term outcomes after extralevator abdominoperineal excision and standard abdominoperineal excision for rectal cancer: A systematic review and meta-analysis[J]. Int J Colorectal Dis, 2014, 29(2): 183-191.

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