Prognosis factors for the perineal incision complications after abdominoperineal resection for low rectal cancer
10.3760/cma.j.issn.0529-5815.2017.11.005
- VernacularTitle: 低位直肠癌腹会阴联合切除术后会阴切口并发症的预后因素分析
- Author:
Shou LUO
1
;
Jianwei LIANG
;
Haitao ZHOU
;
Wei PEI
;
Zhixiang ZHOU
;
Qian LIU
;
Xishan WANG
Author Information
1. Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Colorectal surgery;
Perineal incision complications;
Factor analysis, statistical
- From:
Chinese Journal of Surgery
2017;55(11):842-846
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the prognosis factors affecting perineal incision complications after abdominoperineal resection (APR) for the low rectal cancer.
Methods:This was a retrospective analysis of 151 consecutive patients with low rectal cancer undergoing APR between January and December 2013 at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The patients were comprised of 95 males and 56 females. The mean age of the patients was (57.3±10.9) years (ranging from 31 to 79 years). χ2 test and Logistic regression analysis were used to identify the prognosis factors of perineum incision complications.
Results:In all 151 patients, perineal incision complications were confirmed in 31 patients (20.5%), including 8 cases of incision infection, 22 cases of poor healing of perineal wound, and 1 case of incision fistula formation. In univariate analysis, the factors associated with perineal incision complications were American Society of Anesthesiologists grade (χ2=7.116, P=0.008), intraoperative blood loss (χ2=9.157, P=0.002), while the protective factors associate with perineal incision complications were the intraperitoneal chemotherapy with fluorouracil sustained release (χ2=5.020, P=0.025), pelvic restoration (χ2=10.158, P=0.001), operation experience (χ2=7.334, P=0.007). The gender, age, body mass index, diabetes, preoperative radiochemtherapy, hemoglobin level, albumin level, distance from distal tumor to anal verge, the procedure of APR, operating time, intraoperative blood transfusion, total drainage volume 3 days after operation, tumor differentiation and the postoperative TNM staging were not associated with perineal incision complications (P>0.05). Multivariable logistic regression analysis showed that the intraoperative pelvic restoration (OR=0.200, 95% CI: 0.045 to 0.894, P=0.035) and intraoperative blood loss (OR=2.953, 95% CI: 1.155 to 7.551, P=0.024) were independent prognosis factors of perineum incision complications.
Conclusions:For patients with low rectal cancer undergoing APR procedure, pelvic restoration wound be needed. The operation should be performed by experienced doctors, intraoperative blood loss should be reduced when possible.
