Primary perineal wound closure after preoperative radiotherapy and abdominoperineal resection has a high incidence of wound failure.

摘要: PURPOSE: Neoadjuvant radiation therapy has been used increasingly to downstage rectal cancer and decrease local recurrence. Despite its efficacy, preoperative may inhibit healing contribute wound complications. This study was designed evaluate perineal complications after abdominoperineal resection. METHODS: The clinical records of a consecutive series patients who underwent resection for carcinoma between 1988 2002 were reviewed. Demographic data, disease stage, use recorded. Major included delayed (>1 month), infection requiring drainage/debridement, or reoperation. RESULTS: A total 160 with primary closure the (mean age, 63 ± 12 years); 117 (73 percent) received therapy; 114 (radiation + chemotherapy = 107, alone 7); 3 other pelvic malignancies. Median dose 5,040 (range, 900-5,400) cGY. Overall complication rate 41 percent. 35 Delayed most common (24 percent), followed by (10 percent). Radiation increased risk any (47 vs. 23 percent; P 0.005), major (41 19 0.021), (14 0 0.015). Risk did not correlate gender, smoking, diabetes. CONCLUSIONS: Wound are frequent perineum. Preoperative doubles Alternatives should be considered, particularly therapy.