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Forschungsdatenbank PMU-SQQUID

Myocutaneous flaps and proctocolectomy in severe perianal Crohn"s disease--a single stage procedure.
Schaden, D; Schauer, G; Haas, F; Berger, A
Int J Colorectal Dis. 2007; 22(12):1453-1457
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Schaffler-Schaden Dagmar

Abstract

BACKGROUND
Complex perianal wounds can be extremely difficult to treat and primary closure of these defects can be a challenge even for experienced surgeons. So far, myocutaneous flaps for wound closure after removal of malignant tumors are a well-accepted option, but there are only a few reports focusing on the primary closure of the perineal wound after proctocolectomy for Crohn"s disease. We describe our experience with wide excision of the diseased perineum using a combined abdominoperineal two-team approach.
We performed proctocolectomy with permanent ileostomy in five patients with longstanding extensive Crohn"s disease. All five patients had fistulizing perineal Crohn"s disease combined with Crohn"s colitis. Each patient received at least one flap for primary wound closure, either a rectus abdominis myocutaneous flap or a gracilis flap.
Indication for surgical intervention included anal or bowel stenosis, septic condition, fecal incontinence, or a combination of these features. One patient had a simultaneous adenocarcinoma of the sigmoid colon. Five patients underwent a total of seven flaps. Three months after surgery, complete healing was achieved in all patients; one patient suffered recurrence in the region of his right thigh. Mean follow up was 19.6 months (range-12-43 months).
Myocutaneous flaps are a promising therapeutic option in patients with chronic perianal disease. With the transposition of well-vascularized tissue into the perineal defect, complete healing and control of sepsis can be achieved in the majority of patients.


Useful keywords (using NLM MeSH Indexing)

Adult

Crohn Disease/complications

Crohn Disease/pathology

Crohn Disease/physiopathology

Crohn Disease/surgery*

Female

Follow-Up Studies

Humans

Ileostomy*

Male

Middle Aged

Perineum/pathology

Perineum/physiopathology

Perineum/surgery*

Proctocolectomy, Restorative*

Quality of Life

Rectal Fistula/etiology

Rectal Fistula/pathology

Rectal Fistula/physiopathology

Rectal Fistula/surgery*

Recurrence

Severity of Illness Index

Surgical Flaps*

Time Factors

Treatment Outcome

Wound Healing*


Find related publications in this database (Keywords)

Crohnxxxs disease
myocutaneous flaps
perianal disease
perianal fistula