Exploring the risk factors for perineal wound infection after laparoscopic abdominoperineal resection

Introduction: Perineal wound infection remains a significant complication following abdominoperineal resection (APR), and its associated clinical and financial burden necessitates continued evaluation of modifiable risk factors. This study evaluated surgical and patient-related predictors to inform prevention strategies and postoperative management. Methodology: We conducted a retrospective analysis of 233 consecutive laparoscopic APR procedures performed at a tertiary cancer center between January 2018 and December 2022, examining demographic characteristics, comorbidities, treatment parameters, and operative details. The data were analyzed using SPSS version 26 for descriptive statistics and univariate analysis. Results: The overall infection rate was 21% (49/233). On univariate analysis, significantly higher rates were observed in males (27.7% vs 7.7% in females, P < 0.001), extralevator APR (27.9% vs 15.5%, P = 0.021), and longer operations (mean 325.1 vs 303.9 minutes). On multivariate analysis, only male gender remained an independent predictor of perineal wound infection ( P = 0.003). Conclusion: These findings demonstrate that technical factors (surgical approach, operative duration) and biological variables (gender) substantially influence infection risk. Given the significant healthcare burden of these infections, enhanced perioperative strategies and improved understanding of risk profiles are essential to optimize outcomes.