Secondary coloperineal pull-through and double dynamic graciloplasty aftermiles resection - Feasible, but with a high morbidity

PURPOSE: Until recently, patients who underwent abdominoperineal resections had to cope with a colostomy for the rest of their lives. For some of thes e patients this colostomy was a terrible burden, physically and mentally. P ublications about abdominoperineal pull-through and double dynamic gracilop lasty immediately after a Miles resection showed good results. The purpose of this study was to investigate the procedure as a secondary approach afte r abdominoperineal resections. METHODS: In this study seven patients were e valuated. All had had an abdominoperineal resection and proved to have unbe arable problems with their stoma. All had a secondary pull-through and doub le dynamic graciloplasty, a mean of 8.5 (range, 1.1-34.8) years after the M ites resection. RESULTS: In five patients continence was regained; two were reversed to colostomy because of several complications. Patients who had a successful outcome also suffered from numerous complications, with a total mean hospital stay of 73.8 (range, 27-167) days, a mean of 3.1 (range, 1-6 ) additional operations, and 1.8 (range, 0-4) readmissions. CONCLUSION: Sec ondary anorectal reconstruction after abdominoperineal resection is a feasi ble option, but with a high morbidity. Because of this the procedure was st opped at the beginning of 1997.