One hundred and fifteen patients who had undergone curative APR from 1999 to 2004 at the Moscow State Scientific Center of Coloproctology were reviewed retrospectively. All these procedures were performed for the treatment of adenocarcinoma of the rectum. The series comprised 46 males and 69 females with an average age of 58.0±9.143 years. No patient had undergone pre-operative radiotherapy. The average duration of the operation was 205.7±42.48 min (min. 120, max. 320 min) with a blood loss of 363.3±284.3 ml (from 150 to 1500 ml). 17.4% percent of patients received a blood transfusion, on average 2 units. Indications for transfusion today have markedly changed and most patients do not require transfusion. The perineal wound was primarily closed and drained in 95.7% of patients. Five (4.3%) patients had the perineal space open.
We had no hospital deaths in this series. Postoperative mortality has remained relatively stable over the past two decades and varied from 0 to 4%. The majority of operative mortality in reported series are related with cardiorespiratory and septic complications. While mortality is relatively low, morbidity varied from 15 to 35% [12,13].
In this series, three (2.6%) patients suffered from severe intraoperative complications: ureteral injury, 1 patient; lacerated internal iliac vein, 1 patient; bladder injury, 1 patient; all patients were managed successfully at the same operation. Thirty-four (29.6%) patients developed post-operative complications. Urologic problems constituted the majority of complications.
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