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Updated: Jul 16, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Sex-related differences in postoperative complications after pelvic exenteration and their relationship with surgical
Kei Kimura1, Masataka Igeta2, Yusuke Yatabe3
1Division of Lower GI, Department of Gastroenterological Surgery, Hyogo Medical University, 1-1, Mukogawa, Nishinomiya, 663-8501, Hyogo, Japan. k-kimura@hyo-med.ac.jp.
Purpose:
To investigate the sex-related differences in postoperative complications following pelvic exenteration.
Methods:
This retrospective subanalysis used a multicenter registry of patients who underwent pelvic exenteration for locally advanced or recurrent rectal cancer. We included 218 patients (177 men and 41 women) in this study. The sex-related differences in postoperative complications were evaluated, and sex-by-factor interactions were assessed using logistic regression models, including sex, each perioperative factor, and the corresponding interaction term.
Results:
A significant sex-by-surgical approach interaction was observed for Clavien-Dindo Grade II or higher complications (pinteraction < 0.01). In open surgery, Grade II or higher complications occurred in 82.7% (43/52) of men compared with 38.5% (5/13) of women, whereas no clear sex difference was observed in minimally invasive surgery (69.6% [87/125] vs. 75.0% [21/28]). No significant sex-by-surgical approach interaction was detected for grade III or higher complications. Conversely, a significant sex-by-operative time interaction was observed, which was not apparent for Grade II complications.
Conclusion:
Sex-related differences in postoperative complications after pelvic exenteration were not uniform but emerged with increased surgical invasiveness. Therefore, sex may affect the postoperative risk under conditions of increased surgical stress.
