6. Primary Closure of the Perineal Wound after Combined Abdominoperineal Excision (Miles Operation) for Anorectal Cancer

Traditional methods to the perineal wound after combined abdominoperineal excision (Miles operation) for anorectal cancer employ partial closure of the wound with open-tube drainage or gauze tamponade. The postoperative care of these wound is still troublesome and prolonged. Several weeks are required for final healing when these techniques are adopted. It sometimes takes over half a year when a perineal sinus is occured.In the present study, primary closure of the perineal wound has been used in combination with polyethylene tube drainage of the pelvic dead space formed between peritoneal suture and suture of the levator muscles. The drainage tube without continuous suction was introduced through the distal end of the abdominal wound and was withdrawn 5 to 6 days posteperatively depend upon the daily output.Primary healing was achieved in 8 of total 9 cases one of which was infected and opened.Lesser distress was experienced from the wound and the patients were easily and early mobilized and moved more unimpeded than patients with traditional methods. The postoperative nursing was facilitated and the hospital stay reduced.