{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:38:07Z","timestamp":1783982287996,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T00:00:00Z","timestamp":1536278400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Chemoradiotherapy remains the first line of treatment for anal cancer with surgery reserved for cancer recurrence or persistence. The low incidence of anal cancer means that the numbers undergoing surgery is small with centralization for excision to regional cancer centres. We present our experience of abdominal perineal excision, with reconstruction of the perineal defect (<jats:styled-content style=\"fixed-case\">APERR<\/jats:styled-content>), within a tertiary centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Over a 15\u2010year period, data were collected retrospectively from notes of patients who underwent an <jats:styled-content style=\"fixed-case\">APERR<\/jats:styled-content>. The aim was to look at disease\u2010free and overall survival and complications associated with flap reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study period, 29 patients [median age\u00a0=\u00a062 (range: 42\u201381; interquartile range: 54\u201368) years] underwent <jats:styled-content style=\"fixed-case\">APERR<\/jats:styled-content>. Median follow\u2010up was 77 (4\u2013200) months. Thirteen patients died during follow\u2010up; eight from their disease, with a median survival time of 16 (4\u201363) months. Five\u2010year survival was 67%. Nine (31%) patients had recurrence during the follow up period; this was local (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), regional (<jats:italic>n\u00a0<\/jats:italic>=\u00a04), distant (<jats:italic>n\u00a0<\/jats:italic>=\u00a02) or a combination (<jats:italic>n<\/jats:italic>\u00a0=\u00a01). Sixteen (55%) patients developed 24 complications, including nine (31%) flap complications and 10 (34%) parastomal hernias. Flap complications were flap failure (<jats:italic>n<\/jats:italic>\u00a0=\u00a01) requiring direct closure, flap dehiscence (<jats:italic>n\u00a0<\/jats:italic>=\u00a02), necrosis of flap tip (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), wound infection (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) and a bulky flap (<jats:italic>n<\/jats:italic>\u00a0=\u00a01) requiring liposuction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">APERR<\/jats:styled-content> of anal cancer is a feasible technique with excellent oncological treatment and acceptable long\u2010term complications, although a higher than expected rate of parastomal hernia was noted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14098","type":"journal-article","created":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T23:44:58Z","timestamp":1521935098000},"page":"771-777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Outcome of surgery for recurrent anal cancer: results from a tertiary referral centre"],"prefix":"10.1111","volume":"20","author":[{"given":"M.","family":"Bignell","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Salisbury District Hospital Salisbury UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Chave","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Salisbury District Hospital Salisbury UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Branagan","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Salisbury District 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