Department of Surgery, Glan Clwyd Hospital, Bodelwyddan, Rhyl, Denbighshire LL18 5UJ, UK.
Int J Surg. 2013;11(5):395-9. doi: 10.1016/j.ijsu.2013.02.028. Epub 2013 Mar 14.
Neo-adjuvant chemoradiotherapy is commonly used before surgery for rectal cancer. Very low rectal cancers are still treated by abdominoperineal excision of the rectum (APER). Perineal wound complications are common after APER. There is evidence that radiotherapy increases wound complications. We wished to examine the effect of preoperative radiotherapy (SCPRT) and long course chemoradiotherapy (LCCRT) on perineal wound complications.
We undertook a review of all patients undergoing APER at one institution between 2000 and 2010. Details of SCPRT, LCCRT and both minor and major wound complications were identified by retrospective notes review.
Of 74 patients suitable for analysis, 38 (51%) had recorded wound complications, with 23 (31%) having major wound complications. 43 patients (58%) underwent LCCRT and 11 (15%) SCPRT. Overall wound complications were more common in the LCCRT group than those receiving no treatment (58% vs 30%, p = 0.03), and major wound complications more common after SCPRT than LCCRT (45% vs 35%, p = 0.04) or no treatment (45% vs 10%, p = 0.04). Use of mesh led to more wound complications (71% vs 41%), but almost all of these patients received LCCRT.
Pre-operative LCCRT and SCPRT are both associated with increased perineal wound complications after APER.
新辅助放化疗常用于直肠癌术前。非常低位的直肠癌仍采用经腹会阴直肠切除术（APER）治疗。APER 后会发生常见的会阴伤口并发症。有证据表明放疗会增加伤口并发症。我们希望研究术前放疗（SCPRT）和长程放化疗（LCCRT）对会阴伤口并发症的影响。
我们回顾了 2000 年至 2010 年期间在一家机构接受 APER 的所有患者。通过回顾病历记录，确定了 SCPRT、LCCRT 以及轻微和严重伤口并发症的细节。
在 74 名适合分析的患者中，38 名（51%）有记录的伤口并发症，其中 23 名（31%）有严重伤口并发症。43 名患者（58%）接受了 LCCRT，11 名（15%）接受了 SCPRT。与未接受治疗的患者相比，接受 LCCRT 的患者总体伤口并发症更常见（58%比 30%，p=0.03），接受 SCPRT 的患者严重伤口并发症比接受 LCCRT 或未接受治疗的患者更常见（45%比 35%和 45%比 10%，p=0.04 和 0.04）。使用网片会导致更多的伤口并发症（71%比 41%），但几乎所有这些患者都接受了 LCCRT。
APER 后，术前 LCCRT 和 SCPRT 均与增加的会阴伤口并发症相关。
