[经腹会阴联合切除治疗肛管直肠病变后的会阴伤口并发症]

[Perineal Wound Complications after Abdominoperineal Resection for Anorectal Lesions].

作者信息

Morita Maho, Fujimoto Naoto, Sekido Yuki, Ogino Takayuki, Hata Tsuyoshi, Takahashi Hidekazu, Miyoshi Norikatsu, Uemura Mamoru, Doki Yuichiro, Eguchi Hidetoshi

机构信息

Faculty of Medicine, Medical School, Osaka University.

出版信息

Gan To Kagaku Ryoho. 2022 Dec;49(13):1926-1928.

PMID:36733046

Abstract

BACKGROUND

Perineal wound complications(PWCs)are common after abdominoperineal resection(APR). We examined the incidence of PWCs after APR for anorectal lesions and their risk factors.

METHODS

Patients who underwent APR for anorectal lesions at our hospital from January 2011 to December 2021 were included. Complications of Clavien-Dindo Grade Ⅱ or higher were considered as PWCs.

RESULTS

Eighty-one patients were included; PWCs were observed in 24 patients (29.6%), and associated with a history of Crohn's disease(p=0.018), longer operation time(p=0.040), higher blood loss (p=0.011), extensive perineal resection(p=0.003), and closure with a skin flap(p=0.003). Forty-one patients underwent APR for initial rectal cancer without extended perineal resection, and PWCs were observed in 9 patients(22.0%). Prognostic nutritional index(PNI)<45(p=0.049), smoking(p=0.034), and alcohol consumption(p=0.021)were associated with PWCs.

CONCLUSION

We examined the incidence of PWCs after APR for anorectal lesions and their risk factors. Appropriate intervention in nutrition, smoking, and alcohol consumption may prevent PWCs.

摘要

背景

腹会阴联合切除术（APR）后会阴伤口并发症（PWC）很常见。我们研究了APR治疗肛管直肠病变后PWC的发生率及其危险因素。

方法

纳入2011年1月至2021年12月在我院接受APR治疗肛管直肠病变的患者。Clavien-DindoⅡ级或更高等级的并发症被视为PWC。

结果

纳入81例患者；24例患者（29.6%）观察到PWC，其与克罗恩病病史（p=0.018）、手术时间较长（p=0.040）、失血量较多（p=0.011）、广泛会阴切除术（p=0.003）以及皮瓣闭合（p=0.003）相关。41例患者因原发性直肠癌接受APR且未进行扩大会阴切除术，9例患者（22.0%）观察到PWC。预后营养指数（PNI）<45（p=0.049）、吸烟（p=0.034）和饮酒（p=0.021）与PWC相关。