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Long-term comorbidity of diabetes mellitus is a risk factor for perineal wound complications after an abdominoperineal resection
Authors:Kenji Matsuda  Tsukasa Hotta  Katsunari Takifuji  Shozo Yokoyama  Takashi Higashiguchi  Toshiji Tominaga  Yoshimasa Oku  Toru Nasu  Koichi Tamura  Hiroki Yamaue
Affiliation:(1) Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan
Abstract:Background  This report is an attempt to clarify the effect of diabetes mellitus on perineal wound complications including infectious entities and delayed wound healing after abdominoperineal resection and also tried to show the risk factors for perineal wound complications. Material and methods  The data of 80 patients who underwent an abdominoperineal resection were reviewed from April 1996 to March 2006. Results  The rate of perineal wound complications is higher in diabetics (67%) than in nondiabetics (18%, p = 0.005). In a multivariate analysis, diabetes mellitus and operation time (≥420 min) were the risk factors for perineal wound complications (p = 0.040, p = 0.027, respectively). Infectious perineal wound complication was associated with diabetes mellitus (p < 0.001) but not with the operation time (p = 0.097). Furthermore, a longer comorbid duration of diabetes (≥10 years) was a significant predictor for perineal wound complications (p = 0.008). Conclusion  This study demonstrated diabetes mellitus to be independently associated with perineal wound complications, and when the patients have diabetes mellitus, especially with a longer comorbid duration and longer operation time, the clinical path should be changed to reduce perineal wound complications.
Keywords:Diabetes mellitus  Perineal wound complications  Abdominoperineal resection
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