Risk factors for perineal wound complications following abdominoperineal resection.
OBJECTIVE
Perineal wound complications are common following abdominoperineal resection. This study investigates the factors contributing to these complications.


METHODS
Patients undergoing abdominoperineal resection at our institution from June 1997 to May 2003 were reviewed. Significant predictors associated with minor (separation <2 cm, stitch abscesses, or sinus tracts) or major (>2 cm of separation, reoperation required, or readmission) wound complications were ascertained.


RESULTS
Of 153 patients, there were 22 major (14 percent) and 32 minor (24 percent) wound complications. Patients with anal cancer had a higher rate of major complications than those with rectal cancer or inflammatory bowel disease. Minor wound complications were more common in patients with anal cancer and inflammatory bowel disease than those with rectal cancer. Factors associated with a higher rate of major wound complications included flap closure, tumor size, body mass index, diabetes, and indication for the procedure. When the subset of patients with rectal cancer was considered, higher rates of major wounds were associated with increased body mass index, diabetes, and stage. Minor complications were associated with a two-team approach and increasing body mass index.


CONCLUSIONS
This is currently the largest review of perineal wound complications following abdominoperineal resection. Patients with anal cancer and inflammatory bowel disease were at higher risk for perineal wound complications than those with rectal cancer. Preoperative radiation and primary closure were not associated with increased complications following abdominoperineal resection for rectal cancer.
Christian
Caprice K
CK
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Kwaan
Mary R
MR
Betensky
Rebecca A
RA
Breen
Elizabeth M
EM
Zinner
Michael J
MJ
Bleday
Ronald
R
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000601:surgery*; D015992:Body Mass Index; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000293:injuries* / Q000601:surgery*; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors