The Analysis Of Factors For Impaired Healing Of The Perineal Wound After Abdominoperineal Resection Of Rectal Cancer

Objective:To analyze and evaluate the risk factors for impaired perineal wound healing after abdominoperineal resection of rectum for carcinoma.Methods:The study included 176 patients(110 men,66 women;median age 56.5 years,range:25-83),who underwent abdominoperineal resection of rectum for carcinoma from January 2001 to December 2005 in the Department of Colorectal and Anal Disease,the First Affiliated Hospital of Guangxi Medical University.Impaired healing of the perineal wound was observed in 52(29.5%) of 176 patients.This study investigated twelve factors that might contribute to the failure of perineal wound healing after abdominoperineal resection of rectum for carcinoma:①gender,②age,③BMI(body mass index),④preoperative albumin,⑤nutritional support,⑥diabetes mellitus,⑦hypertension,⑧hepatic metastasis,⑨preoperative radiotherapy,⑩the total amount of the postoperative drainage in the first three days,(11)the partial resection of the posterior vaginal wall in some femal patients,(12)the closure of the pelvic peritoneum.The factors were analyzed by Pearson chi-square test or Fisher's exact test.A P-value of＜0.05 was considered significant.Multivariate statistical technique of logistic regression was also used to identify risk factors.Results:Only the preoperative radiotherapy was statistically significantly associated with impaired wound healing(Pearson chi-square test,P=0.014. logistic regression,P=0.012,OR=2.475).Conclusions:Patients who had an abdominoperineal excision of the rectum were over two times more likely to be prone to impaired healing of the perineal wound if they had preoperative radiation therapy than not.