Pelvic septic complications after rectal cancer surgery
Niyazi Karaman, Lütfi Doğan, Cihangir Özaslan, Can Atalay, Kerim Bora Yılmaz, Mehmet Altınok
Ankara Onkoloji Hastanesi Genel Cerrahi Kliniği, ANKARA
Purpose: The aim of this study was to evaluate the parameters related to septic complications after curative surgery for rectal cancer.
Patients and Methods: Eighty-two patients treated in our clinic with the diagnosis of stage II and III rectal carcinoma have been evaluated retrospectively. The parameters evaluated were age, gender, tumor localisation (lower, mid, upper rectum), the type of surgery (low anterior resection, abdominoperineal resection), the presence of radical abdominopelvic lymph node dissection, emergency or elective surgery, hand sewn or stapled anastomosis, diverting ileostomi or colostomy, peroperative blood transfusion, stage, preoperative albumin and hemoglobin measurements.
Results: The type of surgery was low anterior resection for 42 patients and abdominoperineal resection for 40 patients. Septic complications were seen in 26 (31%) patients. Twelve (14%) of them were anastomotic leak and 14 were pelvic abscess. In univariate analysis, low anterior resection, emergency surgery, preoperative low albumin and hemoglobin levels (≤3gr /dL and ≤11 gr/dL, respectively) were found to increase pelvic septic complications. In multivariate analysis, low anterior resection and low albumin levels were found to be related to pelvic septic complications.
Conclusion: Low rectal anastomosis is a significant risk factor for complications. Preoperative treatment of hypoalbuminemia and anemia and preference of elective surgery are important for this group of patients.
Keywords: Rectum carcinoma, septic complications