AimUncontrolled pelvic sepsis following rectal cancer surgery may lead to dramatic consequences with significant impact on patients' quality of life. The aim of this retrospective observational study is to evaluate management of pelvic sepsis after total mesorectal excision for rectal cancer at a national referral centre.MethodReferred patients with acute or chronic pelvic sepsis after sphincter preserving rectal cancer resection, with the year of referral between 2010 and 2014 (A) or between 2015 and 2020 (B), were included. The main outcome was control of pelvic sepsis at the end of follow‐up, with healed anastomosis with restored faecal stream (RFS) as co‐primary outcome.ResultsIn total 136 patients were included: 49 in group A and 87 in group B. After a median follow‐up of 82 months (interquartile range 35–100) in group A and 42 months (interquartile range 22–60) in group B, control of pelvic sepsis was achieved in all patients who received endoscopic vacuum assisted surgical closure (7/7 and 2/2), in 91% (19/21) and 89% (31/35) of patients who received redo anastomosis (P = 1.000) and in 100% (18/18) and 95% (41/43) of patients who received intersphincteric resection (P = 1.000), respectively. Restorative procedures resulted in a healed anastomosis with RFS in 61% (17/28) of patients in group A and 68% (25/37) of patients in group B (P = 0.567).ConclusionHigh rates of success can be achieved with surgical salvage of pelvic sepsis in a dedicated tertiary referral centre, without significant differences over time. In well selected and motivated patients a healed anastomosis with RFS can be achieved in the majority.

中文翻译：

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直肠癌全直肠系膜切除术后急慢性盆腔脓毒症的治疗——国家转诊中心的 10 年经验

目的直肠癌手术后不受控制的盆腔脓毒症可能会导致严重的后果，对患者的生活质量产生重大影响。这项回顾性观察研究的目的是评估国家转诊中心对直肠癌全直肠系膜切除术后盆腔脓毒症的治疗。方法转诊保留括约肌的直肠癌切除术后患有急性或慢性盆腔脓毒症的患者，转诊年份在 2010 年至 2010 年之间。包括 2014 年 (A) 或 2015 年至 2020 年 (B)。主要结果是随访结束时盆腔脓毒症得到控制，吻合口愈合并恢复粪便流（RFS）作为共同主要结果。结果总共纳入 136 名患者：A 组 49 例，B 组 87 例。 A 组的中位随访时间为 82 个月（四分位间距 35-100），B 组的中位随访时间为 42 个月（四分位间距 22-60），所有接受内镜真空辅助手术闭合的患者均实现了盆腔脓毒症的控制（7 /7 和 2/2），接受重做吻合术的患者分别为 91%（19/21）和 89%（31/35）（磷= 1.000）以及 100%（18/18）和 95%（41/43）接受括约肌间切除术的患者（磷= 1.000），分别。修复手术使 A 组 61% (17/28) 的患者和 B 组 68% (25/37) 的患者通过 RFS 实现吻合口愈合（磷= 0.567）。 结论 在专门的三级转诊中心进行盆腔脓毒症的手术挽救可以实现很高的成功率，并且随着时间的推移不会出现显着差异。在精心挑选和积极主动的患者中，大多数可以通过 RFS 实现愈合的吻合。