TY - JOUR
T1 - Results of treatment of distal rectal carcinoma since the introduction of total mesorectal excision
T2 - A single unit experience, 1994-2003
AU - Chiappa, Antonio A.
AU - Biffi, Roberto
AU - Zbar, Andrew P.
AU - Luca, Fabrizio
AU - Crotti, Cristiano
AU - Bertani, Emilio
AU - Biella, Francesca
AU - Zampino, Giulia
AU - Orecchia, Roberto
AU - Fazio, Nicola
AU - Venturino, Marco
AU - Crosta, Cristiano
AU - Pruneri, Gian Carlo
AU - Grassi, Carmine
AU - Andreoni, Bruno
PY - 2005/5
Y1 - 2005/5
N2 - Background and aims: This study reviewed the results of surgery for distal rectal cancer (where the tumour was within 6 cm of the anal verge) following the introduction of total mesorectal excision for rectal cancer in one institution. Patients and methods: One hundred and fifty-three patients who had undergone elective curative surgical resection of rectal cancer within 6 cm of the anal verge were included. The demographic, operative and follow-up data were collected retrospectively. Comparisons were made between patients who had different surgical procedures. Results: The overall operative mortality rate was nil, and the morbidity 41%. With a mean follow-up of 37 months (range 5-100 months), local recurrence occurred in 18 of the patients. The 5-year actuarial local recurrence rates for double-stapled anastomosis, low-strength anastomosis and abdominoperineal resection (APR) were 39, 17 and 11% respectively. The local recurrence rate was significantly higher for double-stapled low anterior resection than for the other types of operation (P =0.007). On multivariate analysis type of surgery (P =0.025) and tumour stage (P =0.043), were associated with local recurrence, but only stage was a significant prognosticator of overall survival (P =0.0006). Conclusion: With the practice of total mesorectal excision, APR was still necessary in 40% of patients with rectal cancer within 6 cm of the anal verge. The local recurrence rate was lower in patients treated with APR than in those with double-stapled low anterior resection; however, survival rates were similar in these two groups.
AB - Background and aims: This study reviewed the results of surgery for distal rectal cancer (where the tumour was within 6 cm of the anal verge) following the introduction of total mesorectal excision for rectal cancer in one institution. Patients and methods: One hundred and fifty-three patients who had undergone elective curative surgical resection of rectal cancer within 6 cm of the anal verge were included. The demographic, operative and follow-up data were collected retrospectively. Comparisons were made between patients who had different surgical procedures. Results: The overall operative mortality rate was nil, and the morbidity 41%. With a mean follow-up of 37 months (range 5-100 months), local recurrence occurred in 18 of the patients. The 5-year actuarial local recurrence rates for double-stapled anastomosis, low-strength anastomosis and abdominoperineal resection (APR) were 39, 17 and 11% respectively. The local recurrence rate was significantly higher for double-stapled low anterior resection than for the other types of operation (P =0.007). On multivariate analysis type of surgery (P =0.025) and tumour stage (P =0.043), were associated with local recurrence, but only stage was a significant prognosticator of overall survival (P =0.0006). Conclusion: With the practice of total mesorectal excision, APR was still necessary in 40% of patients with rectal cancer within 6 cm of the anal verge. The local recurrence rate was lower in patients treated with APR than in those with double-stapled low anterior resection; however, survival rates were similar in these two groups.
KW - Rectal cancer
KW - Recurrence
KW - Surgery
KW - Survival
KW - Total mesorectal excision
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U2 - 10.1007/s00384-004-0670-9
DO - 10.1007/s00384-004-0670-9
M3 - Article
C2 - 15602647
AN - SCOPUS:20244390610
VL - 20
SP - 221
EP - 230
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
SN - 0179-1958
IS - 3
ER -