Laparoscopic repair of XXXX after abdominoperineal excision.

@entity1 @entity9 @entity547
PURPOSE: Perineal @entity547 is a challenging complication after abdominoperineal excision (APE) of the rectum. Surgical repair can be accomplished using challenging abdominal or transperineal approaches. A laparoscopic repair using a Proceed mesh might be an easy and effective alternative. METHODS: We describe a multi-center case-series of twelve @entity1 with a symptomatic @entity9 treated by laparoscopic mesh repair. A cone-shaped 10  *  15  cm Proceed Mesh was tacked to the promontory or sacrum and sutured to the pelvic sidewalls and the anterior peritoneum. RESULTS: Twelve @entity1 underwent laparoscopic repair of their @entity9 . Four @entity1 and eight @entity1 presented with a symptomatic @entity9 after abdominoperineal excision between 2008 and 2013 and underwent a laparoscopic repair with a Proceed mesh. The median age at presentation was 53  years (range 39-68  years). The mean total theater time was 119  min (range 75-200  min). No conversion to an open procedure was needed. No early complications where seen. The mean hospital stay was 2.25  days (range 1-4  days). Three @entity1 showed recurrence, of whom two had a defect in the middle of the proceed mesh, one had a defect anterior to the previous @entity9 . All 3 @entity1 underwent a redo-laparoscopic repair with mesh. CONCLUSION: In this case series we present an alternative approach for the surgical repair of perineal @entity547 . Based on our experience, @entity9 after APE can be repaired safely and effectively using the described laparoscopic technique.
