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Background: Optimal reconstruction of the perineal defect after extended abdominoperineal excision remains uncertain, and randomized comparisons between biological mesh and myocutaneous flaps are lacking. This trial assessed whether an acellular porcine collagen implant (APCI) is non-inferior to a gluteus maximus myocutaneous flap (GMF) for pelvic floor reconstruction. Methods: NEAPE was a multice
