CARCINOMA OF THE RECTUM - PROFILES OF INTRAOPERATIVE AND EARLY POSTOPERATIVE COMPLICATIONS

PURPOSE: The aim of this study was to determine the incidence and risk factors that were significant in contributing the intraoperative and early postoperative complications for operations of carcinoma of the r ectum. METHODS: Between 1984 and 1986 inclusive, 426 patients underwen t surgery for primary adenocarcinoma of the rectum. Cases of local exc ision were excluded. The relationship between each complication and no minal risk factors were studied. The types of surgery included an abdo minoperineal resection, low anterior resection, low anterior resection with coloanal anastomosis, anterior resection, colostomy, and Hartman n's procedure. RESULTS: There were two (0.5 percent) deaths. Intraoper ative complications occurred in 34 (8 percent) patients. The most comm on intraoperative complication was presacral bleeding which occurred i n 14 patients. Postoperative complications occurred in 214 (50 percent ) patients. The two most common complications were urinary retention a nd urinary tract infection. Abdominoperineal resection had the highest early postoperative complication rate (59 percent). There were 17 cli nical anastomotic leaks (7 percent in 221 patients with unprotected an astomoses). The development of complications reached statistical signi ficance with increasing age (P 0.003), male sex (P = 0.003), increasin g weight (P = 0.006), and types of operative procedure (P = 0.001). CO NCLUSIONS: Operations for carcinoma of the rectum can be performed wit h low mortality. Although the overall early postoperative complication s were high, the majority was not life-threatening and usually resolve d with time and proper management.