{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:59:45Z","timestamp":1776826785377,"version":"3.51.2"},"reference-count":41,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Abdominoperineal resection (APR)\u2014the standard surgical procedure for low-lying rectal cancer (LRC)\u2014leads to significant perineal defects, posing considerable reconstruction challenges that, in selected cases, necessitate the use of plastic surgery techniques (flaps). Purpose: To develop valuable decision algorithms for choosing the appropriate surgical plan for the reconstruction of perineal defects. Methods: Our study included 245 LRC cases treated using APR. Guided by the few available publications in the field, we have designed several personalized decisional algorithms for managing perineal defects considering the following factors: preoperative radiotherapy, intraoperative position, surgical technique, perineal defect volume, and quality of tissues and perforators. The algorithms have been improved continuously during the entire period of our study based on the immediate and remote outcomes. Results: In 239 patients following APR, the direct closing procedure was performed versus 6 cases in which we used various types of flaps for perineal reconstruction. Perineal incisional hernia occurred in 12 patients (5.02%) with direct perineal wound closure versus in none of those reconstructed using flaps. Conclusion: The reduced rate of postoperative complications suggests the efficiency of the proposed decisional algorithms; however, more extended studies are required to categorize them as evidence-based management guide tools.<\/jats:p>","DOI":"10.3390\/curroncol31060247","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T11:48:50Z","timestamp":1717501730000},"page":"3253-3268","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Personalized Decisional Algorithms for Soft Tissue Defect Reconstruction after Abdominoperineal Resection for Low-Lying Rectal Cancers"],"prefix":"10.3390","volume":"31","author":[{"given":"Dan Cristian","family":"Moraru","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Plastic, Reconstructive Surgery and Burns Clinic, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5308-7192","authenticated-orcid":false,"given":"Mihaela","family":"Pertea","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Plastic, Reconstructive Surgery and Burns Clinic, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefana","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Plastic, Reconstructive Surgery and Burns Clinic, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentin","family":"Bejan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"First Surgery Clinic, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrian","family":"Panuta","sequence":"additional","affiliation":[{"name":"Plastic, Reconstructive Surgery and Burns Clinic, \u201cSf. Spiridon\u201d Emergency County Hospital, 700111 Ia\u0219i, Romania"},{"name":"Department of Surgery, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4606-4064","authenticated-orcid":false,"given":"Raluca","family":"Tatar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Plastic, Reconstructive Surgery and Burns, \u201cGrigore Alexandrescu\u201d Clinical Emergency Hospital for Children, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan Mircea","family":"Enescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Plastic, Reconstructive Surgery and Burns, \u201cGrigore Alexandrescu\u201d Clinical Emergency Hospital for Children, 011743 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragos Viorel","family":"Scripcariu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"First Oncological Surgery Clinic, Regional Institute of Oncology (IRO), 700483 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viorel","family":"Scripcariu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"First Oncological Surgery Clinic, Regional Institute of Oncology (IRO), 700483 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3322\/caac.21772","article-title":"Colorectal cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J. 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