Effective Negative Pressure Wound Therapy for a Postoperative Pelvic Dead Space Abscess after Advanced Rectal Cancer Resection—A Case Report—

Abstract

The patient was a 70-year-old man who was referred to our institution with a diagnosis of highly advanced rectal cancer with sacral invasion, bladder invasion, and a pelvic abscess. A colostomy was constructed at the transverse colon, and 10 courses of mFOLFOX6 + panitumumab were administered as chemotherapy. The primary tumor was decreased markedly in size, and the patient underwent total pelvic exenteration combined with sacral resection as conversion surgery. Postoperatively, the patient developed a perineal wound infection mainly at the sacrectomy site, and drainage of the abscess by open wound surgery was not sufficient to improve his condition. Therefore, negative pressure wound therapy was provided, and the patient was discharged from the hospital on the 82nd postoperative day with excellent wound healing. Even in the field of gastrointestinal surgery, many reports have shown the usefulness of negative pressure wound therapy for surgical site infections, which may increase the wound healing rate and shorten the hospital stay. In the present case, negative pressure wound therapy was an effective treatment for a refractory pelvic dead space infection after total pelvic exenteration.