Perineal wound healing after abdominoperineal resection for rectal cancer : a retrospective cohort study
(2022) In International Journal of Colorectal Disease 37(5). p.1029-1034- Abstract
Purpose: Delayed perineal wound healing is a common complication after abdominoperineal resection (APR) in rectal cancer. The primary aim of this study was to evaluate the number of patients with delayed wound healing after APR. Secondary aims were to identify risk factors, and describe treatment. Methods: Prospectively collected data from the Swedish Colorectal Cancer Registry (SCRCR) was used for retrospective analysis of APR performed at Skåne University Hospital Malmö between 2013 and 2018. Medical charts were retrospectively reviewed. Delayed healing was defined as non-healed perineal wound 30 days postoperatively. Patients undergoing extralevator APR requiring reconstruction were excluded. Statistical analysis was made using SPSS.... (More)
Purpose: Delayed perineal wound healing is a common complication after abdominoperineal resection (APR) in rectal cancer. The primary aim of this study was to evaluate the number of patients with delayed wound healing after APR. Secondary aims were to identify risk factors, and describe treatment. Methods: Prospectively collected data from the Swedish Colorectal Cancer Registry (SCRCR) was used for retrospective analysis of APR performed at Skåne University Hospital Malmö between 2013 and 2018. Medical charts were retrospectively reviewed. Delayed healing was defined as non-healed perineal wound 30 days postoperatively. Patients undergoing extralevator APR requiring reconstruction were excluded. Statistical analysis was made using SPSS. Risk factors for impaired wound healing were analyzed using a multivariable model. Results: A total of 162 patients were included, of which 114 underwent standard APR (sAPR) and 48 patients intersphincteric APR (isAPR). In the total population, 69% (111/162) were male, with median age 71 (26–87). The overall healing rate was 52% (85/162); 44% (50/114) in sAPR vs 73% (35/48) in isAPR (P < 0.001). Risk factors for impaired healing after multivariable analysis were BMI > 30 (OR 7.0; CI 95% 1.8–26.2, P = 0.004), reoperation (OR 7.9; CI 95% 1.6–39.8, P = 0.013), neoadjuvant radiotherapy (OR 5.2; CI 95% 1.02–25.1, P = 0.047) and sAPR (OR 2.598; CI 95% 1.05–6.41, P = 0.038). Eight percent (13/162) required an intervention (Clavien-Dindo ≥ 3). Conclusion: Delayed perineal wound healing is a frequent complication after APR but the majority could be treated conservatively. Several risk factors were identified. Further studies aiming at interventions reducing delayed perineal wound healing after APR are warranted.
(Less)
- author
- Hákonarson, Arnar ; Algethami, Nader LU ; Lydrup, Marie Louise LU and Buchwald, Pamela LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Abdominoperineal resection, Intersphincteric APR, Perineal wound healing, Rectal cancer
- in
- International Journal of Colorectal Disease
- volume
- 37
- issue
- 5
- pages
- 6 pages
- publisher
- Springer
- external identifiers
-
- scopus:85127698400
- pmid:35396618
- ISSN
- 0179-1958
- DOI
- 10.1007/s00384-022-04141-7
- language
- English
- LU publication?
- yes
- id
- 59e365b8-1e9c-4ad1-98fd-244b6a317cb0
- date added to LUP
- 2022-06-28 14:20:15
- date last changed
- 2024-06-26 07:34:28
@article{59e365b8-1e9c-4ad1-98fd-244b6a317cb0,
abstract = {{<p>Purpose: Delayed perineal wound healing is a common complication after abdominoperineal resection (APR) in rectal cancer. The primary aim of this study was to evaluate the number of patients with delayed wound healing after APR. Secondary aims were to identify risk factors, and describe treatment. Methods: Prospectively collected data from the Swedish Colorectal Cancer Registry (SCRCR) was used for retrospective analysis of APR performed at Skåne University Hospital Malmö between 2013 and 2018. Medical charts were retrospectively reviewed. Delayed healing was defined as non-healed perineal wound 30 days postoperatively. Patients undergoing extralevator APR requiring reconstruction were excluded. Statistical analysis was made using SPSS. Risk factors for impaired wound healing were analyzed using a multivariable model. Results: A total of 162 patients were included, of which 114 underwent standard APR (sAPR) and 48 patients intersphincteric APR (isAPR). In the total population, 69% (111/162) were male, with median age 71 (26–87). The overall healing rate was 52% (85/162); 44% (50/114) in sAPR vs 73% (35/48) in isAPR (P < 0.001). Risk factors for impaired healing after multivariable analysis were BMI > 30 (OR 7.0; CI 95% 1.8–26.2, P = 0.004), reoperation (OR 7.9; CI 95% 1.6–39.8, P = 0.013), neoadjuvant radiotherapy (OR 5.2; CI 95% 1.02–25.1, P = 0.047) and sAPR (OR 2.598; CI 95% 1.05–6.41, P = 0.038). Eight percent (13/162) required an intervention (Clavien-Dindo ≥ 3). Conclusion: Delayed perineal wound healing is a frequent complication after APR but the majority could be treated conservatively. Several risk factors were identified. Further studies aiming at interventions reducing delayed perineal wound healing after APR are warranted.</p>}},
author = {{Hákonarson, Arnar and Algethami, Nader and Lydrup, Marie Louise and Buchwald, Pamela}},
issn = {{0179-1958}},
keywords = {{Abdominoperineal resection; Intersphincteric APR; Perineal wound healing; Rectal cancer}},
language = {{eng}},
number = {{5}},
pages = {{1029--1034}},
publisher = {{Springer}},
series = {{International Journal of Colorectal Disease}},
title = {{Perineal wound healing after abdominoperineal resection for rectal cancer : a retrospective cohort study}},
url = {{http://dx.doi.org/10.1007/s00384-022-04141-7}},
doi = {{10.1007/s00384-022-04141-7}},
volume = {{37}},
year = {{2022}},
}