Abstract

Background: Our previous experiences suggest a marked improvement of therapeutic results if abdominoperineal resection (APR) is substituted with abdominosacral resection (ASR) in lower-rectal cancer patients. Literature, however, indicates that the impaired wound healing might be associated with the implementation of neoadjuvant radio(chemo)therapy in cases subjected to APR or operated on using a sacral approach. Hence the aim of the study was to assess the frequency of wound healing complications in the clinical records of ASR-operated patients and to check whether it depends on the implementation of preoperative radio(chemo)therapy.

Methods: The analysis included 188 ASR patients, who were divided into three categories depending on the neoadjuvant treatment given: 1) long-term radiochemotherapy (RChT, n=34); 2) short-term radiotherapy (RT, n=20); and 3) no neoadjuvant treatment (n=134). Surgical wound healing was monitored during the initial four weeks (acute complications) or within one year (late complications) after the operation. Moreover, the duration of post-surgical hospitalization was monitored in each patient.

Results: Total frequency of wound healing complications was significantly higher in the RChT patients compared to other groups (47% vs. 15% in RT and 14% in no neoadjuvant groups). There were more cases of superficial (9% vs. 5% and 2%, respectively) and deep (29% vs. 10% in both the remaining groups) wound infections in RChT patients. The duration of postoperative hospitalization was not affected by the type of treatment, whereas it was prolonged by some healing complications.

Conclusions: Improper wound healing is infrequent in ASR-operated patients, unless this procedure was preceded by long-term RChT.

Recommended Citation

Marek Bebenek (2008) "Influence of neoadjuvant radio(chemo)therapy on wound healing in lower-rectal cancer patients subjected to abdominosacral resection (ASR)," World Journal of Colorectal Surgery: Vol. 1 : Iss. 1, Article 10.
Available at: http://services.bepress.com/wjcs/vol1/iss1/art10