为了减轻会阴切除直肠癌或肛门癌后的盆腔伤口问题，有人建议采用多种技术作为一期闭合的替代方法。这些方法包括使用生物/双网、网膜成形术、肌瓣和/或盆腔腹膜闭合术。该网络分析的目的是比较所有用于缓解与空骨盆相关问题的可用手术技术。使用 MEDLINE 数据库 (PubMed)、EMBASE 和 Web of Science 进行了电子系统搜索（最后日期研究日期为 2023 年 3 月 15 日）。包括比较至少两种上述手术技术在腹会阴切除术、盆腔廓清术或额外提肌腹会阴切除术中进行会阴伤口重建的研究。评估会阴伤口的一期愈合、并发症和/或再次干预的发生率。此外，还评估了会阴疝的总体发生率。45 项观察性研究和 5 项随机对照试验符合纳入报告，涉及 146,398 名患者。就主要结局而言，所有手术技术的风险比 (RR) 相当。汇总网络分析显示，将初次闭合（RR 0.53；Crl 0.33、0.89）与肌瓣进行比较时，会阴伤口感染的 RR 较低。与肌瓣相比，网膜成形术（RR 0.59；Crl 0.38，0.95）和初次闭合（RR 0.58；Crl 0.46，0.77）会阴伤口裂开 RR 较低。在过去的几十年里，会阴伤口闭合的手术选择发生了显着变化。对于“最佳”选择仍没有明确的共识，而针对个人的定制仍然是一个关键因素。© 2023。施普林格自然瑞士股份公司。

To mitigate pelvic wound issues following perineal excision of rectal or anal cancer, a number of techniques have been suggested as an alternative to primary closure. These methods include the use of a biological/dual mesh, omentoplasty, muscle flap, and/or pelvic peritoneum closure. The aim of this network analysis was to compare all the available surgical techniques used in the attempt to mitigate issues associated with an empty pelvis.An electronic systematic search using MEDLINE databases (PubMed), EMBASE, and Web of Science was performed (Last date of research was March 15th, 2023). Studies comparing at least two of the aforementioned surgical techniques for perineal wound reconstruction during abdominoperineal resection, pelvic exenteration, or extra levator abdominoperineal excision were included. The incidence of primary healing, complication, and/or reintervention for perineal wound were evaluated. In addition, the overall incidence of perineal hernia was assessed.Forty-five observational studies and five randomized controlled trials were eligible for inclusion reporting on 146,398 patients. All the surgical techniques had a comparable risk ratio (RR) in terms of primary outcomes. The pooled network analysis showed a lower RR for perineal wound infection when comparing primary closure (RR 0.53; Crl 0.33, 0.89) to muscle flap. The perineal wound dehiscence RR was lower when comparing both omentoplasty (RR 0.59; Crl 0.38, 0.95) and primary closure (RR 0.58; Crl 0.46, 0.77) to muscle flap.Surgical options for perineal wound closure have evolved significantly over the last few decades. There remains no clear consensus on the "best" option, and tailoring to the individual remains a critical factor.© 2023. Springer Nature Switzerland AG.