Sex-related differences in postoperative complications after pelvic exenteration and their relationship with surgical invasiveness in a multicenter study
4 affiliations
- 1Division of Lower GI, Department of Gastroenterological Surgery, Hyogo Medical University, 1-1, Mukogawa, Nishinomiya, 663-8501 Hyogo Japan
- 2Department of Biostatistics, Hyogo Medical University, Nishinomiya, Hyogo Japan
- 3Department of Gastrointestinal Surgery, Institute of Science Tokyo, Tokyo, Japan
- 4Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya, Japan
Abstract
Purpose: To investigate the sex-related differences in postoperative complications following pelvic exenteration.
Methods: This retrospective subanalysis used a multicenter registry of patients who underwent pelvic exenteration for locally advanced or recurrent rectal cancer. We included 218 patients (177 men and 41 women) in this study. The sex-related differences in postoperative complications were evaluated, and sex-by-factor interactions were assessed using logistic regression models, including sex, each perioperative factor, and the corresponding interaction term.
Results: A significant sex-by-surgical approach interaction was observed for Clavien–Dindo Grade II or higher complications (pinteraction < 0.01). In open surgery, Grade II or higher complications occurred in 82.7% (43/52) of men compared with 38.5% (5/13) of women, whereas no clear sex difference was observed in minimally invasive surgery (69.6% [87/125] vs. 75.0% [21/28]). No significant sex-by-surgical approach interaction was detected for grade III or higher complications. Conversely, a significant sex-by-operative time interaction was observed, which was not apparent for Grade II complications.
Conclusion: Sex-related differences in postoperative complications after pelvic exenteration were not uniform but emerged with increased surgical invasiveness. Therefore, sex may affect the postoperative risk under conditions of increased surgical stress.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03415-9.
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BibTeX
@article{kimura2026sexrelated,
title = {{Sex-related differences in postoperative complications after pelvic exenteration and their relationship with surgical invasiveness in a multicenter study}},
author = {Kei Kimura and Masataka Igeta and Yusuke Yatabe and Yuko Fukumoto and Kazuma Ito and Ayako Imada and Jihyung Song and Ryuichi Kuwahara and Yuki Horio and Motoi Uchino and Yusuke Kinugasa and Masataka Ikeda},
journal = {Surgery Today},
year = {2026},
month = jul,
doi = {10.1007/s00595-026-03415-9},
url = {https://doi.org/10.1007/s00595-026-03415-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Sex-related differences in postoperative complications after pelvic exenteration and their relationship with surgical invasiveness in a multicenter study
AU - Kei Kimura
AU - Masataka Igeta
AU - Yusuke Yatabe
AU - Yuko Fukumoto
AU - Kazuma Ito
AU - Ayako Imada
AU - Jihyung Song
AU - Ryuichi Kuwahara
AU - Yuki Horio
AU - Motoi Uchino
AU - Yusuke Kinugasa
AU - Masataka Ikeda
PY - 2026
DA - 2026/07/15
JO - Surgery Today
DO - 10.1007/s00595-026-03415-9
UR - https://doi.org/10.1007/s00595-026-03415-9
AB - Purpose: To investigate the sex-related differences in postoperative complications following pelvic exenteration. Methods: This retrospective subanalysis used a multicenter registry of patients who underwent pelvic exenteration for locally advanced or recurrent rectal cancer. We included 218 patients (177 men and 41 women) in this study. The sex-related differences in postoperative complications were evaluated, and sex-by-factor interactions were assessed using logistic regression models, including sex, each perioperative factor, and the corresponding interaction term. Results: A significant sex-by-surgical approach interaction was observed for Clavien–Dindo Grade II or higher complications (pinteraction < 0.01). In open surgery, Grade II or higher complications occurred in 82.7% (43/52) of men compared with 38.5% (5/13) of women, whereas no clear sex difference was observed in minimally invasive surgery (69.6% [87/125] vs. 75.0% [21/28]). No significant sex-by-surgical approach interaction was detected for grade III or higher complications. Conversely, a significant sex-by-operative time interaction was observed, which was not apparent for Grade II complications. Conclusion: Sex-related differences in postoperative complications after pelvic exenteration were not uniform but emerged with increased surgical invasiveness. Therefore, sex may affect the postoperative risk under conditions of increased surgical stress. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03415-9.
SN - 0941-1291
SN - 1436-2813
ER -