Long-term comorbidity of diabetes mellitus is a risk factor for perineal wound complications after an abdominoperineal resection

Matsuda, Kenji; Hotta, Tsukasa; Takifuji, Katsunari; Yokoyama, Shozo; Higashiguchi, Takashi; Tominaga, Toshiji; Oku, Yoshimasa; Nasu, Toru; Tamura, Koichi; Yamaue, Hiroki

doi:10.1007/s00423-008-0381-8

Cited by 22 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This means that comoribidity can have a greater effect on complication in elderly patients. To date, several studies have reported on the effect of comorbidity on gastric cancer surgery(17-19); Kim et al(20) reported that comorbidity was significantly related to postoperative complication after laparoscopic surgery for gastric cancer in a multicenter study of 1,237 patients. However, no study has been conducted for analysis of the effect of comorbidity on increasing age in postoperative complication with a focus on all types of gastric cancer surgery.…”

Section: Discussionmentioning

confidence: 99%

Operative Risk Factors in Gastric Cancer Surgery for Elderly Patients

Seo

Hur

et al. 2011

J Gastric Cancer

View full text Add to dashboard Cite

PurposeGastric cancer surgery is a common operation in East Asia, such as Korea and Japan, and there has been a significant increase in the need for this procedure due to the aging population. As a result, surgery for the treatment of gastric cancer for elderly patients is expected to increase. This study examined the effect of old age on gastric cancer surgery, and analyzed the operative risk factors for elderly patients.Materials and MethodsFrom November 2008 to August 2010, 590 patients, who underwent a curative resection for gastric cancers, were enrolled. Patients who underwent palliative or emergency surgery were excluded. A retrospective analysis of the correlation between surgical outcomes and age was performed. The elderly were defined as patients who were over the age of 65 years.ResultsThe mean age of all patients was 58.3 years, and complications occurred in 87 cases (14.7%). The most common complication was wound infection and severe complications requiring surgical, endoscopic, or radiologic intervention developed in 52 cases (8.8%). The rate of complications increased with increasing age of the patients. Univariate analysis revealed age, comorbidity, extent of resection, operation time, and combined resection to be associated with surgical complications. In particular, age over 75 years old, operation time, and comorbidity were predictive factors in multivariate analysis. In the elderly, only comorbidity was associated with surgical complications.ConclusionsThe patients' age is the most important factor for predicting surgical complications. Surgeons should pay an attention to the performance of gastric cancer surgery on elderly patients. In particular, it must be performed carefully for elderly patients with a comorbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

Operative Risk Factors in Gastric Cancer Surgery for Elderly Patients

Seo

Hur

et al. 2011

J Gastric Cancer

View full text Add to dashboard Cite

show abstract

“…Risk factors for major perineal wound complications following APR are well known: Preoperative radiotherapy, patients with anal cancer, flap reconstruction, tumor size, obesity, and diabetes[7]. Minor wound complications appear more commonly in patients with inflammatory bowel disease or anal cancer than in those with rectal cancer[8].…”

Section: Current Statusmentioning

confidence: 99%

Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review

Schiltz¹,

Buchs²,

Penna³

et al. 2017

WJCO

View full text Add to dashboard Cite

Extralevator abdominoperineal excision and pelvic exenteration are mutilating operations that leave wide perineal wounds. Such large wounds are prone to infection and perineal herniation, and their closure is a major concern to most surgeons. Different approaches to the perineal repair exist, varying from primary or mesh closure to myocutaneous flaps. Each technique has its own associated advantages and potential complications and the ideal approach is still debated. In the present study, we reviewed the current literature and our own local data regarding the use of biological mesh for perineal wound closure. Current evidence suggests that the use of biological mesh carries an acceptable risk of wound complications compared to primary closure and is similar to flap reconstruction. In addition, the rate of perineal hernia is lower in early follow-up, while long-term hernia occurrence appears to be similar between the different techniques. Finally, it is an easy and quick reconstruction method. Although more expensive than primary closure, the cost associated with the use of a biological mesh is at least equal, if not less, than flap reconstruction.

show abstract

“…The presence of a large pelvic dead space is a major cause of morbidity as it predisposes to fluid collections, and subsequent infective collections, which can adversely affect perineal wound healing . The reported incidence of complications such as dehiscence, chronic abscesses, fistulas and delayed healing in patients who undergo direct closure of the perineal wound has been as high as 67% of cases, with even higher rates noted in diabetic and smoking patients, which is compounded in those who have received preoperative radiotherapy . In an attempt to reduce these complications, the use of a vertical rectus abdominus myocutaneous (VRAM) flap to reconstruct the dead space and introduce well‐vascularized healthy tissue has been advocated .…”

Section: Introductionmentioning

confidence: 99%

Morbidity associated with the immediate vertical rectus abdominus myocutaneous flap reconstruction after radical pelvic surgery

et al. 2019

View full text Add to dashboard Cite

Aim Patients who undergo radical pelvic surgery often have problems with perineal wound healing and pelvic collections. While there is recognition of the perineal morbidity, there also remains uncertainty around the benefit of vertical rectus abdominus myocutaneous (VRAM) flaps due to the balance between primary healing and the complications associated with this form of reconstruction. This study aimed to evaluate factors associated with significant flap and donor site related complications following VRAM flap reconstruction for radical pelvic surgery.

show abstract

Long-term comorbidity of diabetes mellitus is a risk factor for perineal wound complications after an abdominoperineal resection

Cited by 22 publications

References 20 publications

Operative Risk Factors in Gastric Cancer Surgery for Elderly Patients

Operative Risk Factors in Gastric Cancer Surgery for Elderly Patients

Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review

Morbidity associated with the immediate vertical rectus abdominus myocutaneous flap reconstruction after radical pelvic surgery

Contact Info

Product

Resources

About