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News

Wound dehiscence after abdominoperineal resection for rectal cancer decreases survival

Wound dehiscence after abdominoperineal resection for low rectal cancer is associated with decreased survival, finds the latest issue of the Diseases of the Colon & Rectum.

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Abdominoperineal resection for low rectal adenocarcinoma is a common procedure with high morbidity, including perineal wound complications.

Dr Alexander Hawkins and colleagues determined risk factors for perineal wound dehiscence, and to investigate the effect of wound dehiscence on survival.

The research team performed a retrospective medical chart review in a tertiary care university medical center.

Patients included in the study were those with low rectal adenocarcinoma who underwent abdominoperineal resection between 2001 and 2012.

27% of patients developed wound dehiscence
Diseases of the Colon & Rectum

The team assessed the incidence of perineal wound dehiscence, as well as survival, after surgery.

A total of 249 patients underwent abdominoperineal resection for rectal carcinoma.

The researchers reported that the mean age was 63 years, and 64% were male, and the mean BMI was 28.

There were 61% patients who survived for 5 years after surgery.

The research team noted that 27% of patients developed wound dehiscence.

The team found that BMI, IBD, history of other malignant neoplasm, and abdominoperineal resection for cancer recurrence were associated with dehiscence.

In the survival analysis, wound dehiscence was associated with decreased survival.

The team observed that this relationship persisted in the multivariable analysis.

Dr Hawkins' team concludes, "The adjusted risk of death was 1.7 times higher in patients who experienced dehiscence than in those who did not."

"Attention to perineal wound closure with consideration of flap creation should at least be given to patients with a history of malignant neoplasm, those with IBD, those with rectal cancer recurrence, and women undergoing posterior vaginectomy."

"Preoperative weight loss should also reduce dehiscence risk."

Dis Colon Rectum 2014: 57(2): 143–150
03 February 2014

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