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Perineal wound complication risk factors and effects on survival after abdominoperineal resection of rectal cancer: a single-centre retrospective study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

This study determined the risk factors associated with perineal wound complications (PWCs) and investigated their effect on overall survival in patients with rectal cancer who underwent abdominoperineal resection (APR).

Methods

The clinicopathologic and follow-up data of patients who underwent APR for primary rectal cancer between 1998 and 2018 were reviewed. PWCs were defined as any perineal wound that required surgical intervention, antibiotics, or delayed healing for more than 2 weeks. The primary objective was identifying the risk factors of PWC after APR. The effect of PWC on survival was also investigated as a secondary objective.

Results

Two hundred and twenty patients were included in the final analyses and 49 had PWCs. An operative time of > 285 min (odds ratio: 2.440, 95% confidence interval (CI): 1.257–4.889) was found to be independently associated with PWCs. When the follow-up time was > 60 months, patients with PWCs had a significantly lower overall survival rate than patients without PWC (n = 156; mean over survival: 187 and 164 months in patients without and with PWCs, respectively; P = 0.045). Poor differentiation (hazard ratio (HR): 1.893, 95% CI: 1.127–3.179), lymph node metastasis (HR: 2.063, 95% CI: 1.228–3.467), and distant metastasis (HR: 3.046, 95% CI: 1.551–5.983) were associated with poor prognosis.

Conclusion

Prolonged operative time increases the risk of PWCs, and patients with PWCs have a lower long-term survival rate than patients without PWCs. Therefore, surgeons should aim to reduce the operative time to minimise the risk of PWC in patients undergoing APR for rectal cancer.

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Data availability

The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by funding received from the Peking University People’s Hospital Scientific Research Development Funds (RDY2019-27).

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China

    Chao Wang, Zhanlong Shen, Kewei Jiang, Zhidong Gao & Yingjiang Ye

  2. Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China

    Chao Wang, Zhanlong Shen, Zhidong Gao & Yingjiang Ye

  3. Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China

    Chao Wang, Kewei Jiang & Yingjiang Ye

  4. Gastrointestinal Cancer Centre, Peking University Cancer Hospital, Beijing, 100142, People’s Republic of China

    Junyu You

Authors
  1. Chao Wang
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  2. Junyu You
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  3. Zhanlong Shen
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  4. Kewei Jiang
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Contributions

Study concepts: Yingjiang Ye. Study design: Zhidong Gao. Data acquisition: Chao Wang and Junyu You. Data analysis and interpretation: Zhanlong Shen. Statistical analysis: Kewei Jiang. Manuscript preparation: Chao Wang and Zhidong Gao. Manuscript review: Yingjiang Ye.

Corresponding authors

Correspondence to Zhidong Gao or Yingjiang Ye.

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The authors declare that they have no conflicts of interest.

Ethics approval

This study was conducted in accordance with the STROBE statement and approved by the Ethics Committee of Peking University People’s Hospital (Beijing, China).

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Authors Chao Wang and Junyu You own equal rights to first authorship

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Wang, C., You, J., Shen, Z. et al. Perineal wound complication risk factors and effects on survival after abdominoperineal resection of rectal cancer: a single-centre retrospective study. Int J Colorectal Dis 36, 821–830 (2021). https://doi.org/10.1007/s00384-021-03840-x

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