Morbidity and mortality following abdominoperineal resection for rectal adenocarcinoma.

From 1979 through 1986, 56 patients, 38 males (68%) and 18 females (32%), underwent an abdominoperineal resection with a wide perineal dissection for primary adenocarcinoma of the rectum. The open perineal wounds required a mean time of 6 months to completely heal. Estimated blood loss by the surgeon ranged from 200 ml to 4200 ml with a mean of 1112 ml and a median of 1000 ml. Twenty-six patients (46%) developed postoperative or intraoperative complications. Nineteen patients (34%) underwent incidental surgery with no associated morbidity. The most commonly occurring complication was impotence in 69% of male patients. The next most common complication was bladder dysfunction with urinary retention in 14 patients (25%) and urinary incontinence in five patients (9%). There were two postoperative deaths (4%). Although the morbidity was significant, greater than 90% of the complications were treatable and resolved without major sequellae.