MORBIDITY AND MORTALITY FOLLOWING ABDOMINOPERINEAL RESECTION FOR RECTAL ADENOCARCINOMA

From 1979 through 1986, 56 patients, 38 males (68%) and 18 females (32 %), underwent an abdominoperineal resection with a wide perineal disse ction for primary adenocarcinoma of the rectum. The open perineal woun ds required a mean time of 6 months to completely heal. Estimated bloo d loss by the surgeon ranged from 200 ml to 4200 ml with a mean of 111 2 ml and a median of 1000 ml. Twenty-six patients (46%) developed post operative or intraoperative complications. Nineteen patients (34%) und erwent incidental surgery with no associated morbidity. The most commo nly occurring complication was impotence in 69% of male patients. The next most common complication was bladder dysfunction with urinary ret ention in 14 patients (25%) and urinary incontinence in five patients (9%). There were two postoperative deaths (4%). Although the morbidity was significant, greater than 90% of the complications were treatable and resolved without major sequellae.