Prise en charge des pertes de substance périnéales après amputation abdominopérinéale

Although many options are available, ranging from direct closure to flap reconstruction, the management of perineal wounds after abdominoperineal resection remains challenging. A better understanding of the aims, drawbacks and progress in perineal wound management after abdominoperineal amputation can help the surgeon to make better choices for each patient, but it is very difficult to propose a single, optimal, evidence-based procedure for the management of pelvic exenteration. Recent progress provided by the extralevator abdominoperineal excision technique and perforator flap concepts have changed our conception of reconstruction leading to different reconstruction options highlighted in this review.