Objective: To evaluate the role of constitutional, clinical and surgical factors in the development of wound complications following midline laparotomy for endometrial cancer.Methods: A database created for a multicentric randomized clinicaltrial comparing two different methods of fascial closure was used to identify patients undergoing total or radical hysterectomy through a midline laparotomy for endometrial cancer. A total of 617 patients were followed to detect the occurrence of early (infection, dehiscence) and late (incisional hernia) postoperative wound complications.Patients who presented an early and/or late woundcomplication (Group 1, n¼513), were compared to those who didnot (Group 2, n¼104).Results: The median patients age was significantly higher in Group1 than in Group 2 (67 [45—81] vs 63 [30—94] years, p<.05). Theproportion of women with diabetes was 21% in Group 1 comparedto 10% in Group 2 (p<.01). The median (range) BMI was higher inpatients who developed a wound complication than in those whodid not (29 [20—48] vs 26 [10—51] kg/m2, p<.05). The closure of thefascia was more frequently performed by experienced surgeons inGroup 1 compared to Group 2 (68.4% vs 49.5%, p<.001). Multiplelogistic regression analysis showed that the presence of diabeteswas the only independent risk factor for wound complications(OR 2.24 [CI 1.28—3.91], p<.005).Conclusions: Wound complications following gynecologic surgeryfor endometrial cancer seem to be related to metabolic disorderssuch as diabetes more than to surgical technique or other coexisting medical conditions.

Wound complications after midline laparotomy in endometrial cancer patients. A multicentric trial.

BERGAMINI, VALENTINO;FRANCHI, Massimo Piergiuseppe
2004

Abstract

Objective: To evaluate the role of constitutional, clinical and surgical factors in the development of wound complications following midline laparotomy for endometrial cancer.Methods: A database created for a multicentric randomized clinicaltrial comparing two different methods of fascial closure was used to identify patients undergoing total or radical hysterectomy through a midline laparotomy for endometrial cancer. A total of 617 patients were followed to detect the occurrence of early (infection, dehiscence) and late (incisional hernia) postoperative wound complications.Patients who presented an early and/or late woundcomplication (Group 1, n¼513), were compared to those who didnot (Group 2, n¼104).Results: The median patients age was significantly higher in Group1 than in Group 2 (67 [45—81] vs 63 [30—94] years, p<.05). Theproportion of women with diabetes was 21% in Group 1 comparedto 10% in Group 2 (p<.01). The median (range) BMI was higher inpatients who developed a wound complication than in those whodid not (29 [20—48] vs 26 [10—51] kg/m2, p<.05). The closure of thefascia was more frequently performed by experienced surgeons inGroup 1 compared to Group 2 (68.4% vs 49.5%, p<.001). Multiplelogistic regression analysis showed that the presence of diabeteswas the only independent risk factor for wound complications(OR 2.24 [CI 1.28—3.91], p<.005).Conclusions: Wound complications following gynecologic surgeryfor endometrial cancer seem to be related to metabolic disorderssuch as diabetes more than to surgical technique or other coexisting medical conditions.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/428575
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