Evaluation of sphincter-preserving surgery for rectal cancer (original) (raw)
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Sphincter-saving surgeries for rectal cancer: A single center study from Kashmir
South Asian Journal of Cancer, 2013
Summary and Background Data: The goals in the treatment of rectal cancer are cure, local control, and preservation of sphincter, bladder and sexual function. Surgical resection using sharp mesorectal dissection is important for achieving these goals. Objectives: The current treatment of choice for carcinoma rectum is sphincter saving procedures, which have practically replaced the previously done abdominoperineal resection. We performed a study in our institute to evaluate the surgical outcome and complications of rectal cancer. Materials and Methods: This prospectivestudy included 117 patients, treated for primary rectal cancer by low anterior resection (LAR) from May 2007 to December 2010. All patients underwent standard total mesorectal excision (TME) followed by restoration of continuity. Results: The peri-operative mortality rate was 2.5% (3/117). Post-operative complications occurred in 32% of the patients. After a median follow up of 42 months, local recurrences developed in ...
Sphincter Saving Techniques in Low Rectal Cancer Surgical Treatment: Results, Perspectives
Acta Medica Marisiensis, 2015
Objective: Sphincter saving techniques in low rectal cancer represents a challenge for the surgeons in their attempt to preserve the sphincter function and also to respect the principles of oncological surgery, in order to improve the quality of the patient’s life. The paper’s aim is to compare different sphincter saving techniques in regards to the early postoperative results.Methods: An observational, retrospective study was performed on 76 patients (N = 76) operated for low rectal cancer in the Surgical Clinic no.1 of the Targu Mures Emergency Clinical County Hospital, between January 2010 and October 2014, to whom the rectal resection was followed by a primary restorative technique for preservation of the sphincter function. The immediate postoperative results after different types of sphincter saving procedures were analyzed and compared.Results: From the studied patients, in 41 cases (53.94%) an anterior rectal resection with low colorectal anastomosis was done („very low” Dix...
Surgical Endoscopy, 2005
Background: Although experience of laparoscopic treatment of rectal carcinoma has been reported, there is no evidence of its oncological safety because most procedures included partial mesorectal excision or abdominoperineal excision and quality of surgery is lacking. The aim of this study was to assess the oncological results of laparoscopic total mesorectal excision with sphincter preservation for rectal carcinoma. Methods: From 2000 to 2003, 144 patients underwent laparoscopic total mesorectal excision with low colorectal or coloanal anastomosis for mid and low rectal adenocarcinoma. There were 88 men and 56 women, with a median age of 65 years. The tumor was located at 5.5 cm (range 1-12) from the anal verge and was classified uT1T2 in 25 cases and uT3 in 119 cases. One hundred twenty patients received preoperative radiotherapy. Results: Postoperative mortality and morbidity were 1% and 34% respectively. Conversion was 14% (n = 20). Macroscopic assessment of the specimen (n = 92) showed an intact mesorectum in 88% of the cases. The distal margin and the circumferential margin were safe in 98% and 94% of the cases, respectively. A complete microscopic excision, i.e., R0 resection, was achieved in 134 cases (93%). Pathological data were similar to those of an open match group. With a median follow-up of 18 months, there was no port-site recurrence and two patients had local recurrence (1.4%). The 3-year overall and disease-free survival rates were 89% and 77%, respectively.
2019
Introduction: Intersphincteric resection of low rectal tumors.is a surgical technique extending rectal resection into the intersphincteric space. This procedure is performed by a synchronous abdominoperineal approach with mesorectal. excision and excision of the entire or part of the internal sphincter. Aim of the Work: is to evaluate the oncological and functional outcome of classic abdominoperineal resection (APR) compared to sphincter sparing ( intersphincteric resection) (ISR) procedures. Patient: Group A patients (10 patients): who meet the criteria of ISR possibility and candidates for sphincter preserving procedures Group B patients (10 patients): Who didn’t meet the criteria to do Original Research Article Abdelhamid et al.; AJRS, 2(1): 1-5, 2019; Article no.AJRS.49169 2 ISR, were subjected to APR. The number of the patients in this short research article were small as it is a preliminary study. Methods: Total ISR involves complete excision of the internal sphincter. The cut...
Sphincter-Preserving Surgery for Low Rectal Cancer: Do We Overshoot the Mark?
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2016
Intersphincteric resection (ISR) is an alternative to abdominoperineal resection (APR) for a selected subset of patients with low rectal cancer, combining equivalent oncological outcome and sphincter preservation. However, functional results are heterogeneous and often imperfect. The aim of the present investigation was to determine the long-term functional results and quality of life after ISR. One hundred forty-three consecutive patients who underwent surgery for low rectal cancer were analysed. Sixty patients received ISR and 83 patients APR, respectively. Kaplan-Meier estimate was used to analyse patients' survival. The EORTC QLQ-C30, -C29 and the Wexner score were used to determine functional outcome and quality of life. ISR and APR were both associated with comparable morbidity and no mortality. Patients' disease- and recurrence-free survival after ISR and APR were similar (p = 0.2872 and p = 0.4635). Closure of ileostomy was performed in 73% of all patients after ISR....
Results of Surgery in Carcinoma Rectum with Sphincter Preservation
2017
Introduction: Cancer o fcolon and rectum is the most common cancer of the gastrointestinal tract.Various factors are attributed to interplay between environmental,dietary factors and lifestyle of the patients with carcinoma rectum. Objective: This article covers the profile of these patients,comparison for complications rates between hand sewen anastomosis and circular stapled anastomosis ,recurrence rates,disease free and overall survival, different adjuvant regimes in patients undergoing sphincter preservation surgery. Materials and methods: 70 Patients (carcinoma rectum proven)with growth between 6-12cm from analverge were taken from July 2007 to June 2010 and were followed upto december2010. Result: This study revealed that carcinoma rectum has slightly more male prepondrance with bleeding per rectum as the most common symptom.46patients underwent circular stapled anastomosis and 24 patients underwent handsewen anastomosis.Most common complication postoperatively was anastomotic...
Long-term functional results after sphincter-saving resection for rectal cancer
Gastroentérologie Clinique et Biologique, 2004
Introduction -A number of patients suffer from gastrointestinal side effects following sphincter-saving resection of the rectum. The aim of this study was to assess frequency and risk factors of long-term gastrointestinal side effects after sphincter-saving resection for rectal cancer.
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014
Rectal cancer management has evolved into a complex multimodality approach with survival, local recurrence, and quality of life parameters being the relevant endpoints. Surgical treatment for low rectal cancer has changed dramatically over the past 100 years. Abdominoperineal resection, once the standard of care for all rectal cancers, has become much less frequently utilized as surgeons devise and test new techniques for preserving the sphincters, maintaining continuity, and performing oncologically sound ultra-low anterior or local resections. Progress in rectal cancer surgery has been driven by improved understanding of the anatomy and pathophysiology of the disease, innovative surgical technique, improved technology, multimodality approaches, and increased appreciation of the patient's quality of life. The patient with a low rectal cancer, once almost universally destined for impotence and a colostomy, now has the real potential for improved survival, avoidance of a permanen...