{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:08:18Z","timestamp":1784110098290,"version":"3.55.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Today"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the sex-related differences in postoperative complications following pelvic exenteration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant sex-by-surgical approach interaction was observed for Clavien\u2013Dindo Grade II or higher complications (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      &lt; 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00595-026-03415-9","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T09:29:29Z","timestamp":1784107769000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex-related differences in postoperative complications after pelvic exenteration and their relationship with surgical invasiveness in a multicenter study"],"prefix":"10.1007","author":[{"given":"Kei","family":"Kimura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Igeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Yatabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Fukumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuma","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Imada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihyung","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Kuwahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Horio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoi","family":"Uchino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kinugasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"3415_CR1","doi-asserted-by":"publisher","first-page":"2790","DOI":"10.1245\/s10434-020-09247-2","volume":"28","author":"HT Vigneswaran","year":"2021","unstructured":"Vigneswaran HT, Schwarzman LS, Madueke IC, David SM, Nordenstam J, Moreira D, et al. Morbidity and Mortality of Total Pelvic Exenteration for Malignancy in the US. Ann Surg Oncol. 2021;28:2790\u2013800.","journal-title":"Ann Surg Oncol"},{"key":"3415_CR2","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1016\/j.ejso.2021.12.472","volume":"48","author":"CK Pleth Nielsen","year":"2022","unstructured":"Pleth Nielsen CK, S\u00f8rensen MM, Christensen HK, Funder JA. Complications and survival after total pelvic exenteration. Eur J Surg Oncol. 2022;48:1362\u20137.","journal-title":"Eur J Surg Oncol"},{"key":"3415_CR3","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1111\/codi.16476","volume":"25","author":"EM Burns","year":"2023","unstructured":"Burns EM, Quyn A. The \u2018Pelvic exenteration lexicon\u2019: Creating a common language for complex pelvic cancer surgery. Colorectal Dis. 2023;25:888\u201396.","journal-title":"Colorectal Dis"},{"key":"3415_CR4","unstructured":"Garrett C, Brown KGM, Solomon MJ, Sutton PA, Koh CE, Aguiar S Jr., et al. Conventional Versus High-Complexity Total Pelvic Exenteration For Locally Advanced and Locally Recurrent Rectal Cancer: An International Multicenter Study. Dis Colon Rectum; 2025."},{"key":"3415_CR5","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1093\/bjs\/znab070","volume":"108","author":"S Rajendran","year":"2021","unstructured":"Rajendran S, Brown KGM, Solomon MJ, Austin KKS, Lee PJ, Robinson D, et al. Complete resection of the iliac vascular system during pelvic exenteration: an evolving surgical approach to lateral compartment excision. Br J Surg. 2021;108:885\u20137.","journal-title":"Br J Surg"},{"key":"3415_CR6","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1111\/ans.18220","volume":"93","author":"T Fitzsimmons","year":"2023","unstructured":"Fitzsimmons T, Thomas M, Tonkin D, Murphy E, Hollington P, Solomon M, et al. Establishing a state-wide pelvic exenteration multidisciplinary team meeting in South Australia. 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