Risk factors for impaired healing of the perineal wound after abdominoperineal resection of rectum for carcinoma

Artioukh, D. Y.; Smith, Randall A.; Gokul, Krishnan

doi:10.1111/j.1463-1318.2006.01159.x

Cited by 123 publications

(100 citation statements)

References 22 publications

(19 reference statements)

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“…9,13,14 This finding is not consistent in the literature. One study suggests that there was no significant increase in the risk of major wound complications in rectal cancer patients undergoing preoperative radiation but that patients with anal cancer who had preop- erative radiation may be at risk.…”

Section: Discussioncontrasting

confidence: 87%

Factors affecting the healing of the perineum following surgery

Jones

Bassett

2013

annals

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North West London Hospitals NHS Trust, UK aBStract INTRODUCTION The aim of this study was to establish patient and procedural factors associated with the development of an unhealed perineum in patients undergoing a proctectomy or excision of an ileoanal pouch. METHODS A review of 194 case notes for procedures performed between 1997 and 2009 was carried out. All patients had at least 12 months' follow-up. Univariate and multivariate analyses were performed in 16 parameters. For those patients who developed an unhealed perineum, Cox regression analysis was performed to establish healing over a 12-month period. RESULTS Two hundred patients were included in the study, of which six had unknown wound status and were subsequently excluded. This left 194 study patients. Of these, 86 (44%) achieved primary wound healing with a fully healed perineum and 108 (56%) experienced primary wound failure. With reference to the latter, 63 (58%) healed by 12 months. Comparing patients with an initially intact perineum with those with initial wound failure showed pre-existing sepsis was highly relevant (odds ratio: 4.32, 95% confidence interval [CI]: 2.16-8.62, p<0.001). In patients who had an unhealed perineum initially, perineal sepsis and surgical treatment were both significantly associated with time to healing (hazard ratio [HR]: 0.54, p=0.03; and HR: 0.42, p=0.01). CONCLUSIONS The presence of pre-existing perineal sepsis is associated with an unhealed perineum following proctectomy in inflammatory bowel disease (IBD) and non-IBD surgery. Further studies are indicated to establish perineal sepsis as a causative factor.

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Section: Discussioncontrasting

confidence: 87%

Factors affecting the healing of the perineum following surgery

Jones

Bassett

2013

annals

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“…In fact, perineal wound dehiscence and infection has been a well-recognized complication following abdominoperineal resection in patients undergoing neoadjuvant chemoradiation. 18,19 Even though prospective randomized studies have showed no differences in the incidence of anastomotic leaks, several retrospective analyses of large series of patients have identified the use of preoperative radiation therapy as one of the significant predictors of clinically relevant leaks. 1,20,21 Complications after transanal endoscopic surgery have been well documented to be approximately 4% in most retrospective case series.…”

Section: Discussionmentioning

confidence: 99%

Transanal Endoscopic Microsurgery for Residual Rectal Cancer After Neoadjuvant Chemoradiation Therapy Is Associated With Significant Immediate Pain and Hospital Readmission Rates

Perez¹,

Habr‐Gama²,

Julião³

et al. 2011

Diseases of the Colon &Amp; Rectum

151

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Transanal local excision with the use of endoscopic microsurgical approach may result in significant postoperative morbidity, wound dehiscence, and readmission rates, in particular, because of rectal pain secondary to wound dehiscence. In this setting, the benefits of this minimally invasive approach either for diagnostic or therapeutic purposes become significantly restricted to highly selected patients that can potentially avoid a major operation but will still face a significantly morbid and painful procedure.

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“…Luna-Perez et al [8] reported the perineal wound infection rate of 14.6% in their study. Artioukh et al [9] reported impaired healing of the perineal wound in 10 (26%) of 38 patients and found that 4 of them (11%) the wound remained unhealed in 1 year after surgery. The complications of colostomy in this study were peristomal skin irritation, 10 (19.6%) cases, ischaemia, single (1.9%) case in early postoperative period and a single case each of prolapse (1.9%) and stricture (1.9%) were found as late complications.…”

Section: Methodsmentioning

confidence: 99%

Early and Late Complications Following Surgery for Rectal Carcinoma: Study of 56 Cases

Kalyanwat¹

2016

jmscr

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Risk factors for impaired healing of the perineal wound after abdominoperineal resection of rectum for carcinoma

Cited by 123 publications

References 22 publications

Factors affecting the healing of the perineum following surgery

Factors affecting the healing of the perineum following surgery

Transanal Endoscopic Microsurgery for Residual Rectal Cancer After Neoadjuvant Chemoradiation Therapy Is Associated With Significant Immediate Pain and Hospital Readmission Rates

Early and Late Complications Following Surgery for Rectal Carcinoma: Study of 56 Cases

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