Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection
Abstract. Background:. For the rectal cancer <5 cm from anal margin, extralevator abdominoperineal resection (eAPR) has been accepted widely by surgeons. However, the rate of perineal infection following up eAPR is approximately 70%. We did the study with the aim of evaluating the effect and safe...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-04-01
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| Series: | Medicine |
| Online Access: | http://journals.lww.com/10.1097/MD.0000000000029104 |
| _version_ | 1818205949241851904 |
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| author | An Shang, MM Min Wang, MD Yongping Yang, MD Zeyun Zhao, MM Donglin Li, MM Yu Guo, MM Rui Qi, MM Yang Yang, MM Shuang Wang, MD Wen-Wei Sung. |
| author_facet | An Shang, MM Min Wang, MD Yongping Yang, MD Zeyun Zhao, MM Donglin Li, MM Yu Guo, MM Rui Qi, MM Yang Yang, MM Shuang Wang, MD Wen-Wei Sung. |
| author_sort | An Shang, MM |
| collection | DOAJ |
| description | Abstract. Background:. For the rectal cancer <5 cm from anal margin, extralevator abdominoperineal resection (eAPR) has been accepted widely by surgeons. However, the rate of perineal infection following up eAPR is approximately 70%. We did the study with the aim of evaluating the effect and safety of transperineal pelvic drainage combined with lateral position (TPDLP) on perineal wound in patients undergoing eAPR.
Methods:. Patients were randomly assigned to N-TPDLP group (standard arm) or TPDLP group (intervention arm). In the standard arm, surgery was completed after abdominal drainage tube was placed in pelvic. Comparatively, an additional transperineal wound drainage tube was applied in the experimental arm. Postoperatively, patients of both 2 groups were informed not to sit to reduce perineal compression until the perineal wound healed. But lateral position was demanded in the intervention arm. The primary endpoint was the rate of uncomplicated perineal wound healing defined as a Southampton wound score of <2 at 30 days postoperatively. Patients were followed for 6 months.
Results:. In total, 60 patients were randomly assigned to standard arm (n = 31) and intervention arm (n = 29). The mean perineal wound healing time was 34.2 (standard deviation [SD] 10.9) days in TPDLP arm, which significantly differ from 56.4 (SD 34.1) in N-TPDLP arm (P = .001). At 30 days postoperatively, 3 (10%) of 29 patients undergoing TPDLP were classified into grade 4 according to Southampton wound score, however, 16 (52%) of 31 patients were classified into grade 4 in control arm, and significantly difference was observed between randomization groups (P = .001). What's more, perineal wound pain was assessed at 30 days postoperatively, and it is discovered that the pain degree of patients in control arm was significantly more severe than the interventive arm (P = .015).
Conclusion:. In the present study, we found that TPDLP generated a favorable prognosis for perineal wounds with acceptable side-effects. |
| first_indexed | 2024-12-12T04:05:15Z |
| format | Article |
| id | doaj.art-cdb33b4a44fc4d9f86654591aaf7c531 |
| institution | Directory Open Access Journal |
| issn | 0025-7974 1536-5964 |
| language | English |
| last_indexed | 2024-12-12T04:05:15Z |
| publishDate | 2022-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Medicine |
| spelling | doaj.art-cdb33b4a44fc4d9f86654591aaf7c5312022-12-22T00:38:48ZengWolters KluwerMedicine0025-79741536-59642022-04-0110114e2910410.1097/MD.0000000000029104202204080-00004Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resectionAn Shang, MMMin Wang, MDYongping Yang, MDZeyun Zhao, MMDonglin Li, MMYu Guo, MMRui Qi, MMYang Yang, MMShuang Wang, MDWen-Wei Sung.Abstract. Background:. For the rectal cancer <5 cm from anal margin, extralevator abdominoperineal resection (eAPR) has been accepted widely by surgeons. However, the rate of perineal infection following up eAPR is approximately 70%. We did the study with the aim of evaluating the effect and safety of transperineal pelvic drainage combined with lateral position (TPDLP) on perineal wound in patients undergoing eAPR. Methods:. Patients were randomly assigned to N-TPDLP group (standard arm) or TPDLP group (intervention arm). In the standard arm, surgery was completed after abdominal drainage tube was placed in pelvic. Comparatively, an additional transperineal wound drainage tube was applied in the experimental arm. Postoperatively, patients of both 2 groups were informed not to sit to reduce perineal compression until the perineal wound healed. But lateral position was demanded in the intervention arm. The primary endpoint was the rate of uncomplicated perineal wound healing defined as a Southampton wound score of <2 at 30 days postoperatively. Patients were followed for 6 months. Results:. In total, 60 patients were randomly assigned to standard arm (n = 31) and intervention arm (n = 29). The mean perineal wound healing time was 34.2 (standard deviation [SD] 10.9) days in TPDLP arm, which significantly differ from 56.4 (SD 34.1) in N-TPDLP arm (P = .001). At 30 days postoperatively, 3 (10%) of 29 patients undergoing TPDLP were classified into grade 4 according to Southampton wound score, however, 16 (52%) of 31 patients were classified into grade 4 in control arm, and significantly difference was observed between randomization groups (P = .001). What's more, perineal wound pain was assessed at 30 days postoperatively, and it is discovered that the pain degree of patients in control arm was significantly more severe than the interventive arm (P = .015). Conclusion:. In the present study, we found that TPDLP generated a favorable prognosis for perineal wounds with acceptable side-effects.http://journals.lww.com/10.1097/MD.0000000000029104 |
| spellingShingle | An Shang, MM Min Wang, MD Yongping Yang, MD Zeyun Zhao, MM Donglin Li, MM Yu Guo, MM Rui Qi, MM Yang Yang, MM Shuang Wang, MD Wen-Wei Sung. Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection Medicine |
| title | Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection |
| title_full | Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection |
| title_fullStr | Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection |
| title_full_unstemmed | Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection |
| title_short | Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection |
| title_sort | transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection |
| url | http://journals.lww.com/10.1097/MD.0000000000029104 |
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