World Journal of Surgery

, Volume 29, Issue 11, pp 1452–1457 | Cite as

Salvage Abdominoperineal Resection and Perineal Wound Healing in Local Recurrent or Persistent Anal Cancer

  • Floris T.J. Ferenschild
  • Maarten Vermaas
  • Stefan O. Hofer
  • Cornelis Verhoef
  • Alexander M.M. Eggermont
  • Johannes H.W. de Wilt
Article
First Online:

Abstract

The primary treatment for anal cancer is chemoradiation (CRT). Failures after CRT are potentially curable with an abdominoperineal resection (APR). A major problem of surgery in the anal area is poor healing of the perineal wound. Between 1985 and 2000, 129 patients treated for anal cancer were retrospectively reviewed. Of the 24 patients with local failure, 18 patients were treated with an APR. The aim of this study was to review the results and long-term outcome after salvage APR, with special emphasis on perineal wound healing. Mean age at diagnosis was 59 (range: 41–83) years. After a median of 16 months, only 2 patients developed a local recurrence. The 5-year overall survival was 30%. In 11 patients the perineal wound was closed primarily, in 3 patients the perineal wound was left open, and in 4 patients a vertical rectus abdominus musculocutaneous (VRAM) flap was used. Perineal wound breakdown occurred in 5 of the 14 patients (36%) not treated with primary muscle reconstruction. In all patients treated with a VRAM flap the perineal wound healed primarily. In the present study salvage APR in recurrent or persistent anal cancer results in good local control and 5-year overall survival of 30%. When performing an APR a VRAM flap reconstruction should be considered to prevent disabling perineal wound complications.

Keywords

Anal Cancer Perineal Wound Good Local Control Perineal Hernia Anal Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Acknowledgments

The authors thank Wilfried Graveland for his support with the statistical analysis.

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Copyright information

© Société Internationale de Chirurgie 2005

Authors and Affiliations

  • Floris T.J. Ferenschild
    • 1
  • Maarten Vermaas
    • 1
  • Stefan O. Hofer
    • 2
  • Cornelis Verhoef
    • 1
  • Alexander M.M. Eggermont
    • 1
  • Johannes H.W. de Wilt
    • 1
  1. 1.Department of Surgical OncologyErasmus MC–Daniel den Hoed Cancer CenterRotterdamThe Netherlands
  2. 2.Department of Plastic SurgeryErasmus MC–Daniel den Hoed Cancer CenterRotterdamThe Netherlands

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