Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review

Table 1 Perineal reconstruction with biological mesh

Ref.	Study type	Operation	No.of patients	Averageage (median years)	Perineal complications (%)	Surgical perineal debridementn	Perineal hernias	Follow up	Comments
Musters BIOPEX-study 2016[29]	RCT	ELAPE	50	65	37% overall perineal wound complications	4% surgical drainage of perineal abscess, 6% percutaneous drainage of perineal abscess	13% at 1 yr	12 mo
Jensen et al[30], 2014	Cohort, prospective	ELAPE	53	NR	21% perineal fistula, 7.5% superficial perineal abscess, 7.5% deep perineal abscess	5 (9%) fistulectomy, 8 (15%) surgical debridements	5.60%	Median 36 mo	1 mesh removed (infection), 1 mesh failure (hole) replacement of a new mesh
Christensen et al[24], 2011	Cohort, retrospective	ELAPE	24	69.7	17%, with one fistula after 3 mo	0	0	Median 1.7 yr	-
Han et al[28], 2010	Cohort, retrospective	ELAPE	12	68	16% infection, 8% seroma	0	NR	Median 8 mo	-
Han et al[27], 2012	Derived from RCT	ELAPE	32	68	11.4% wound infections 11% seroma	NR	14%	NR	-
Peacock et al[31], 2014	Cohort, prospective	ELAPE	34	62	32% overall; 9% superficial wound infections, 14% perineal fistula; 9% perineal abscess	3 (9%) surgical debridement/VAC therapy	0	Median 21 mo	-
Schiltz present study	Cohort, retrospective	ELAPE + PE	11	63	Overall 27% wound infections with 1 superficial	2 (18%) surgical debridement	0	Mean 18 mo	-

NR: Not reported; ELAPE: Extralevator abdominoperineal excision; PE: Pelvic exenteration.