Septic complications and prognosis after surgery for rectal cancer.
OBJECTIVE
The influence of septic complications on long-term prognosis after surgery for rectal cancer is controversial. This study was performed to investigate whether an abdominal or perineal septic complication was associated with rectal cancer recurrence.


METHODS
A total of 228 patients who had undergone curative resection for rectal cancer from 1973 to 1992 were reviewed. The patients were divided into groups of those who developed either an intra-abdominal abscess or a perineal infection after surgery (infection group) and those who did not (noninfection group).


RESULTS
There was no clear difference in the overall incidence of tumor recurrence between the infection group (19/53, 36 percent) and the noninfection group (46/175, 26 percent; P = 0.25). However, the incidence of local recurrence was higher in the infection group (12/53, 23 percent) than in the noninfection group (16/175, 9 percent; P = 0.02). This increased risk was restricted to patients with a perineal infection (10/30, 33 percent; P = 0.003 vs. the noninfection group), whereas patients with an abdominal infection (3/24, 13 percent) did not differ from the noninfection group.


CONCLUSIONS
Patients with a perineal infection after an abdominoperineal resection have an increased incidence of local recurrence. However, there was no association between abdominal sepsis and prognosis after surgery for rectal cancer.
Kressner
Ulf
U
Department of Surgery, University Hospital, University of Uppsala, Sweden.
Graf
Wilhelm
W
Mahteme
Haile
H
Påhlman
Lars
L
Glimelius
Bengt
B
D018784:Abdominal Abscess / Q000150:complications* / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality; D011183:Postoperative Complications; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000401:mortality; D013530:Surgical Wound Infection / Q000150:complications* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors