{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T23:50:10Z","timestamp":1750895410456},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T00:00:00Z","timestamp":1527724800000},"content-version":"vor","delay-in-days":0,"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":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Extralevator abdominoperineal resection (<jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content>) may be complicated by perineal wound healing problems and herniation. We report a consecutive series of 38 such patients with selective use of a fasciocutaneous V\u2010Y buttock advancement flap (<jats:styled-content style=\"fixed-case\">BAF<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data were collected on a series of patients undergoing <jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content> for rectal malignancy between August 2011 and July 2017. Demographics, management and outcomes were recorded prospectively. Perineal wound problems were considered as \u2018major\u2019 if they required packing; otherwise, they were classed as \u2018minor\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010eight patients [eight female and 30 male; median age 63 (range: 35\u201389) years] underwent <jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content>. Thirty\u2010seven had an adenocarcinoma of the rectum and one had a malignant melanoma. The median tumour height (from the anal verge) was 30 (range: 0\u201380) mm. Sixteen patients had a <jats:styled-content style=\"fixed-case\">BAF<\/jats:styled-content>. The median length of stay was 10 (range: 6\u201325) days. Primary perineal healing occurred in 18 (47%) patients. Major wound breakdown occurred in three (10%) patients and minor wound breakdown in 17 (45%). Two of the 16 patients having a <jats:styled-content style=\"fixed-case\">BAF<\/jats:styled-content> had major wound breakdown: one wound took 9\u00a0weeks to heal completely and the other took 9\u00a0months. Of the 22 patients who did not have a <jats:styled-content style=\"fixed-case\">BAF<\/jats:styled-content>, one had a major wound breakdown which closed by 3\u00a0months. There were no perineal fistulae or chronic sinuses. There were two perineal herniae that were successfully repaired by perineal insertion of biological mesh (Permacol\u2122; Covidien, Dublin, Ireland).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Selective use of a <jats:styled-content style=\"fixed-case\">BAF<\/jats:styled-content> for perineal closure can give good results in terms of healing and an acceptably low early perineal herniation rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14258","type":"journal-article","created":{"date-parts":[[2018,5,12]],"date-time":"2018-05-12T09:20:18Z","timestamp":1526116818000},"page":"981-985","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Perineal closure following extralevator abdominoperineal excision for cancer of the rectum"],"prefix":"10.1111","volume":"20","author":[{"given":"J.","family":"Barrie","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Royal Blackburn Hospital Blackburn United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Haque","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Blackburn Hospital Blackburn United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. A.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Blackburn Hospital Blackburn United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0827-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1992.tb00014.x"},{"key":"e_1_2_8_4_1","first-page":"510","article-title":"Gracilis myocutaneous flap for reconstructing perineal defects resulting from radiation and radical surgery","volume":"26","author":"Palmer J","year":"1983","journal-title":"Can J Surg"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1990.01410230080014"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199702000-00004"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-008-0607-9"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12492"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4400-x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-016-1495-6"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002020"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13423"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12843"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3182163c89"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2011.10.001"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12286"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.14258","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T08:08:47Z","timestamp":1694333327000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.14258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,31]]},"references-count":15,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/codi.14258"],"URL":"https:\/\/doi.org\/10.1111\/codi.14258","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,31]]},"assertion":[{"value":"2017-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}