Evaluation of Surgical and Non-Surgical Approaches in the Management of Perineal Infections in Patients with Leukemia: A Retrospective Study

Abstract

Introduction: Improvement of perineal infections in immunocompromised patients is usually done in different ways from other diseases, because these people usually have multiple problems and less power in dealing with diseases due to weak immune system. In the majority of cases, patients with malignancy present with anal pain and fever undergo clinical examination and incision under anesthesia even without evidence of edema or collection, while medical treatment in these patients may reduce the need for surgery. Therefore, the aim of this study was to investigate surgical and non-surgical approaches in the management of perineal infections in patients with cancers in Taleghani Hospital.

Material & methods: This study was a cross-sectional descriptive-analytical study on patients with leukemia who referred to Taleghani Hospital in Tehran due to perineal infection. Demographic information, mortality rate as well as type of disease and type of treatment as well as blood cell count including white blood cells, platelets and neutrophils and clinical signs of all patients were evaluated and finally the data were analyzed by SPSS software.

Results: Fifty patients with leukemia who underwent surgical or medical treatment for perineal infections were evaluated. The mean age of patients in this study was 36.6 ±11.95 years. Among patients, 21 (42%) were female and 29 (58%) were male. The most common leukemia's in patients were ALL, Hodgkin's lymphoma and AML with frequencies of 54%, 28% and 10%, respectively, and their most common clinical symptoms were pain, fever and chills (46%). 24 patients (48%) underwent surgery and 26 patients (52%) underwent medical treatment. In those who underwent surgical treatment, 37.5% died and in those who underwent medical treatment, 11.5% died (p-value = 0.001). The type of treatment was not related to age, sex, type of cancer and white blood cell and platelet count of patients, but a significant relationship was observed with patients' clinical symptoms. Also, the mean number of white blood cells and platelets in people who died was significantly lower than other people (p-value = 0.001).

Conclusion: Considering the prevalence of mortality in patients who underwent surgery, patient management through medical and conservative treatment can be effective in reducing mortality and in selected patients can be without imposing anesthesia and incision to the patient, Follow up the patient with medical treatment and prevented surgical stress.