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[Perineal Wound Complications after Abdominoperineal Resection for Anorectal Lesions]
Maho Morita1, Naoto Fujimoto, Yuki Sekido
1Faculty of Medicine, Medical School, Osaka University.
Insights
Perineal wound complications (PWCs) after abdominoperineal resection (APR) for anorectal lesions occur in 29.6% of patients. Risk factors include Crohn's disease, longer operations, and extensive resection, highlighting the need for targeted interventions.
Area of Science:
- Surgical Oncology
- Colorectal Surgery
- Wound Healing
Context:
- Perineal wound complications (PWCs) are a significant concern following abdominoperineal resection (APR) for anorectal conditions.
- Understanding the incidence and risk factors for PWCs is crucial for improving patient outcomes.
Purpose:
- To determine the incidence of perineal wound complications (PWCs) after abdominoperineal resection (APR) for anorectal lesions.
- To identify patient- and procedure-related risk factors associated with PWCs in this population.
Summary:
- A retrospective review of 81 patients undergoing APR for anorectal lesions identified a PWC incidence of 29.6%.
- Significant risk factors for PWCs included a history of Crohn's disease, prolonged operative time, increased blood loss, extensive perineal resection, and skin flap closure.
- For patients without extensive perineal resection (n=41), PWCs occurred in 22.0% and were associated with a prognostic nutritional index (PNI) < 45, smoking, and alcohol consumption.
Impact:
- Findings underscore the importance of addressing nutritional status, smoking cessation, and alcohol consumption to mitigate PWC risk.
- This research can inform surgical planning and postoperative care strategies to reduce the morbidity associated with APR.
Background:
Perineal wound complications(PWCs)are common after abdominoperineal resection(APR). We examined the incidence of PWCs after APR for anorectal lesions and their risk factors.
Methods:
Patients who underwent APR for anorectal lesions at our hospital from January 2011 to December 2021 were included. Complications of Clavien-Dindo Grade Ⅱ or higher were considered as PWCs.
Results:
Eighty-one patients were included; PWCs were observed in 24 patients (29.6%), and associated with a history of Crohn's disease(p=0.018), longer operation time(p=0.040), higher blood loss (p=0.011), extensive perineal resection(p=0.003), and closure with a skin flap(p=0.003). Forty-one patients underwent APR for initial rectal cancer without extended perineal resection, and PWCs were observed in 9 patients(22.0%). Prognostic nutritional index(PNI)<45(p=0.049), smoking(p=0.034), and alcohol consumption(p=0.021)were associated with PWCs.
Conclusion:
We examined the incidence of PWCs after APR for anorectal lesions and their risk factors. Appropriate intervention in nutrition, smoking, and alcohol consumption may prevent PWCs.
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