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Related Experiment Video

Updated: Feb 24, 2026

Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
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Persistent perineal sinus after abdominoperineal resection.

Amélie Chau1, Mathieu Prodeau1, Hélène Sarter2,3

  • 1Digestive Surgery and Transplantation Unit, Hôpital Huriez, Lille Nord de France University, Lille University Medical Center, 59000, Lille, France.

Langenbeck'S Archives of Surgery
|August 26, 2017
PubMed
Summary
This summary is machine-generated.

Persistent perineal sinus (PPS) after abdominoperineal resection (APR) is common in Crohn's disease (CD) patients, often healing over time. Younger age and colonic-only CD location increase PPS risk.

Keywords:
Abdominoperineal resectionCrohn’s diseasePersistent perineal sinus

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Area of Science:

  • Colorectal surgery
  • Gastroenterology
  • Surgical complications

Background:

  • Persistent perineal sinus (PPS) is a known complication following abdominoperineal resection (APR).
  • The incidence and long-term outcomes of PPS in Crohn's disease (CD) patients, particularly in the era of biotherapy, require further investigation.
  • Understanding risk factors for delayed perineal healing is crucial for patient management.

Purpose of the Study:

  • To evaluate the incidence of PPS after APR for CD during the biotherapy era.
  • To determine the long-term outcome of PPS in CD patients.
  • To identify risk factors for delayed perineal healing and compare outcomes with non-CD patients.

Main Methods:

  • Retrospective study of patients undergoing APR for CD or non-CD rectal cancer (1997-2013).
  • Clinical evaluation of perineal healing at 1, 6, and 12 months post-surgery.
  • Comparison of PPS incidence and healing rates between CD and non-CD groups.

Main Results:

  • The cumulative probability of unhealed perineal wounds at 6 and 12 months was significantly higher in CD patients (85% and 48%) compared to non-CD patients (21% and 13%).
  • 10% of CD patients had persistent PPS after a median follow-up of 4 years, while all non-CD patients achieved spontaneous healing.
  • Factors associated with delayed healing in CD included age < 49 years and colonic-only disease location; medical treatments showed no significant impact.

Conclusions:

  • Persistent perineal sinus (PPS) after APR is frequent in Crohn's disease (CD) patients but generally resolves over time.
  • Age at surgery < 49 years and colonic-only CD location are identified risk factors for PPS.
  • Muscle flap reconstruction during APR warrants evaluation for PPS prevention in CD patients.