Mudabbir Hussain.
Effective drainage of perineum after abdomino-perineal excision for carcinoma rectum reduces local complications.
Pak J Surg Jan ;19(2):68-71.

This is a personal series of 33 consecutive patients that underwent abdominoperineal resection for rectal carcinoma carried out at Southampton University Hospitals, Royal Hampshire County Hospital, Hinchingbrooke Hospital and Northern General Hospital, U.K. Indications for resection included the height of the tumour (mean 5.24 cm from the anal verge), cellular differentiation, extent of spread and perforation. The peritoneal floor was reconstituted but the levators were not approximated. The peritoneal wound was closed primarily in all cases. Suction drains were placed in the perineal space. The buttocks were approximated using an adhesive dressing and the patients nursed lying on their side. Uncomplicated primary healing occurred in 31 (94%) of perineal wounds. One pelvic abscess required drainage and one wound broke down. Both subsequently healed. There was one chronic sinus and one perineal hernia. The significant morbidity of perineal wound failure can be minimised by effective drainage of the pre-sacral space and particular attention to reducing stresses on the perineal wound.

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