Ying Guo1, Eugene Chang2, Mehtap Bozkurt3, Minjeong Park4, Diane Liu4, Jack B Fu1. 1. Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. Department of Medicine, Division of Physical Medicine and Rehabilitation, Toronto Rehabilitation Institute, Toronto, Canada. 3. Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakir, Turkey. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND AND OBJECTIVES: Total pelvic exenteration are performed in patients with locally advanced or recurrent pelvic malignances. Many patients have prolong hospital length of stay (LOS), but risk factors are not clearly identified. METHODS: From 2002 through 2012, 100 consecutive patients undergoing pelvic exenteration were retrospectively reviewed. A general linear model was used to examine risk factors for prolonged hospital LOS. RESULTS: Among the 100 patients, 51 had gastrointestinal cancer, 14 had genitourinary cancer, 31 had gynecologic cancer, and 4 had sarcoma. Perioperative complications included infection (n = 44), anastomotic leak/fistula (n = 6), wound or flap dehiscence (n = 11), and ileus or bowel obstruction (n = 30). The median (Interquartile range (IQR)) hospital LOS was 15 days (10-21.5 days). On multivariate regression analysis, hospital LOS was significantly prolonged by underweight status, genitourinary cancer or sarcoma diagnosis, ≥2 infections, anastomotic leak/fistula, requiring rehabilitation consult and admission, and ≥2 consultations (P = 0.05). CONCLUSION: In patients undergoing pelvic exenteration, prolonged hospital LOS is associated with underweight status, genitourinary cancer or sarcoma diagnosis, more than one infection, anastomotic leak/fistula, requiring rehabilitation consult and admission, and more than one consultation. Further study is needed to assess whether minimizing these risk factors can improve hospital LOS in these patients.
BACKGROUND AND OBJECTIVES: Total pelvic exenteration are performed in patients with locally advanced or recurrent pelvic malignances. Many patients have prolong hospital length of stay (LOS), but risk factors are not clearly identified. METHODS: From 2002 through 2012, 100 consecutive patients undergoing pelvic exenteration were retrospectively reviewed. A general linear model was used to examine risk factors for prolonged hospital LOS. RESULTS: Among the 100 patients, 51 had gastrointestinal cancer, 14 had genitourinary cancer, 31 had gynecologic cancer, and 4 had sarcoma. Perioperative complications included infection (n = 44), anastomotic leak/fistula (n = 6), wound or flap dehiscence (n = 11), and ileus or bowel obstruction (n = 30). The median (Interquartile range (IQR)) hospital LOS was 15 days (10-21.5 days). On multivariate regression analysis, hospital LOS was significantly prolonged by underweight status, genitourinary cancer or sarcoma diagnosis, ≥2 infections, anastomotic leak/fistula, requiring rehabilitation consult and admission, and ≥2 consultations (P = 0.05). CONCLUSION: In patients undergoing pelvic exenteration, prolonged hospital LOS is associated with underweight status, genitourinary cancer or sarcoma diagnosis, more than one infection, anastomotic leak/fistula, requiring rehabilitation consult and admission, and more than one consultation. Further study is needed to assess whether minimizing these risk factors can improve hospital LOS in these patients.
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