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document
[ Management of the perineal wounds after abdominoperineal resection : simple drainage only or with continuous irrigation ? ] . OBJECTIVE To compare the effects of presacral irrigation and simple drainage on the perineal wound healing in patients after abdominoperineal resection ( APR ) . METHODS From October 2004 to August 2009 , patients with rectal cancer , ulcerative colitis or rectal gastrointestinal stromal tumor , who underwent APR or proctocolectomy , were randomized into two arms : simple drainage group ( n = 37 ) and continuous irrigation ( n = 37 ) . Patients randomized to arm B received simple drainage only to presacral space ; while those patients in arm A received continuous irrigation in addition to simple drainage . Perineal wound healing was taken as endpoint of this study . Major complication was defined as wound dehiscence or wound infection that the perineal wound should be reopened for drainage . Minor complication was defined as delayed healing wound with seroma or hematoma . RESULTS A total of 74 patients were enrolled in present study , with 37 patients in each arm , and there were 12 cases and 10 cases who received preoperative radiation therapy , respectively . In the arm A , 2 patients developed major complications , 3 patients incurred with minor complications and 32 patients got primary healing of the perineal wounds . In arm B , 8 patients suffered major complications , 3 patients incurred with minor complications and 26 patients got primary healing of the perineal wounds . The incidence of major complication was significantly lower in arm A ( 5.4 % vs.21.6 % , P = 0.042 ) . Patients received preoperative radiation therapy had significantly higher rate of minor complications than patients underwent surgery only ( 18.2 % vs. 3.9 % , P = 0.039 ) . CONCLUSIONS Simple drainage with continuous irrigation of the presacral space , in patients with abdominoperineal resection or proctocolectomy , could significantly lower the incidence of major complication and improve wound healing for perineal wound when compared with simple drainage only . Preoperative radiation therapy tends to increase the incidence of minor complications .
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Intervention_Physical
simple drainage
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Intervention_Physical
continuous irrigation
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Intervention_Physical
presacral irrigation
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Intervention_Physical
simple drainage
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Intervention_Surgical
abdominoperineal resection ( APR )
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Intervention_Surgical
APR
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Intervention_Surgical
proctocolectomy
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Intervention_Physical
simple drainage
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Intervention_Physical
continuous irrigation
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Intervention_Physical
simple drainage
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Intervention_Physical
continuous irrigation
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Intervention_Physical
Simple drainage with continuous irrigation
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Intervention_Surgical
of the presacral space
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Outcome_Adverse-effects
wound dehiscence
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Outcome_Adverse-effects
wound infection
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Outcome_Adverse-effects
perineal wound should be reopened for drainage
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Outcome_Physical
delayed healing wound with seroma or hematoma
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Outcome_Physical
healing
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Outcome_Adverse-effects
incidence of major complication
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Outcome_Physical
rate of minor complications
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Participant_Condition
abdominoperineal resection ( APR )
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Participant_Condition
rectal cancer
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Participant_Condition
ulcerative colitis
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Participant_Condition
rectal gastrointestinal stromal tumor
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Participant_Sample-size
74