Petrelli N, Rosenfield L, Herrera L, Mittelman A
J Surg Oncol. 1986 Jul;32(3):138-40. doi: 10.1002/jso.2930320303.
The clinical charts of 44 patients who underwent an abdominoperineal resection for adenocarcinoma of the rectum at Roswell Park Memorial Institute were retrospectively reviewed. The morbidity of an open perineal wound versus the closed perineal wound were evaluated. All of the patients received a Nichol's bowel preparation and following the abdominal portion of the dissection reperitonealization of the pelvic floor was performed. The overall morbidity for the open perineal wounds was 21% compared to a morbidity of 63% for the perineal wounds that were closed primarily. The mean length of hospitalization from the time of abdominoperineal resection was 21 days for the open perineal group and 22 days for the closed perineal group. The inclusion of wound sinus tracts in our morbidity assessment may explain the higher complication rate of the closed wound group than previously reported in the literature. This retrospective review emphasizes that the morbidity of the open perineal wound following abdominoperineal resection has been overemphasized. One is trading a potentially increased incidence of septic wound complications in the closed perineum for a protracted wound closure in the open perineum.
对罗斯韦尔帕克纪念研究所44例因直肠癌接受腹会阴联合切除术的患者临床病历进行回顾性分析。评估开放会阴伤口与闭合会阴伤口的发病率。所有患者均接受了尼科尔肠道准备，在腹部手术部分完成后，进行盆底再腹膜化。开放会阴伤口的总体发病率为21%，而一期闭合会阴伤口的发病率为63%。开放会阴组从腹会阴切除术后的平均住院时间为21天，闭合会阴组为22天。在发病率评估中纳入伤口窦道可能解释了闭合伤口组并发症发生率高于以往文献报道的原因。这项回顾性分析强调，腹会阴切除术后开放会阴伤口的发病率被过度强调了。人们是在用闭合会阴中感染性伤口并发症发生率的潜在增加，来换取开放会阴中伤口愈合时间的延长。
