Laparoscopic and Conventional Resections for Low Rectal Cancers: A Retrospective Analysis on Perioperative Outcomes, Sphincter Preservation, and Oncological Results

2012 ◽  
Vol 22 (7) ◽  
pp. 625-630 ◽  
Author(s):  
Cem Gezen ◽  
Yunus E. Altuntas ◽  
Metin Kement ◽  
Nihat Aksakal ◽  
Nuri Okkabaz ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Sphincter Preservation ◽  
Perioperative Outcomes ◽  
Rectal Cancers ◽  
Oncological Results

Safety and feasibility of sphincter preservation surgery in low lying rectal cancers

2021 ◽  
Author(s):  
Swapnil Patel ◽  
Vivek Sukumar ◽  
Mufaddal Kazi ◽  
Avanish Saklani
Keyword(s):  
Sphincter Preservation ◽  
Rectal Cancers

scholarly journals Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer

2020 ◽  
Vol 24 (10) ◽  
pp. 1025-1034 ◽  
Author(s):  
G. Sun ◽  
Z. Lou ◽  
H. Zhang ◽  
G. Y. Yu ◽  
K. Zheng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Wall ◽  
Anal Verge ◽  
Disease Free Survival ◽  
Sphincter Preservation ◽  
Low Rectal Cancer ◽  
Anal Function ◽  
Oncological Outcomes ◽  
Rectal Cancers ◽  
Very Low Rectal Cancer

Abstract Background Conformal sphincter preservation operation (CSPO) is a new surgical procedure for very low rectal cancers (within 4–5 cm from the anal verge). CSPO preserves more of the dentate line and distal rectal wall and also avoids injuring nerves in the intersphincteric space, resulting in satisfactory anal function after resection. The aim of this study was to analyze the short-term surgical results and long-term oncological and functional outcomes of CSPO. Methods Consecutive patients with very low rectal cancer, who had CSPO between January 2011 and October 2018 at Changhai Hospital, Shanghai were included. Patient demographics, clinicopathological features, oncological outcomes and anal function were analyzed. Results A total of 102 patients (67 men) with a mean age of 56.9 ± 10.8 years were included. The median distance of the tumor from the anal verge was 3 (IQR, 3–4) cm. Thirty-five patients received neoadjuvant chemoradiation (nCRT). The median distal resection margin (DRM) was 0.5 (IQR, 0.3–0.8) cm. One patient had a positive DRM. All circumferential margins were negative. There was no perioperative mortality. The postoperative complication rate was 19.6%. The median duration of follow-up was 28 (IQR, 12–45.5) months. The local recurrence rate was 2% and distant metastasis rate was 10.8%. The 3-year overall survival and disease-free survival rates were 100% and 83.9%, respectively. The mean Wexner incontinence and low anterior resection syndrome scores 12 months after ileostomy reversal were 5.9 ± 4.3, and 29.2 ± 6.9, respectively. Conclusions For patients with very low rectal cancers, fecal continence can be preserved with CSPO without compromising oncological results.

Preoperative Radiotherapy With or Without Concurrent Fluorouracil and Leucovorin in T3-4 Rectal Cancers: Results of FFCD 9203

2006 ◽  
Vol 24 (28) ◽  
pp. 4620-4625 ◽  
Author(s):  
Jean-Pierre Gérard ◽  
Thierry Conroy ◽  
Franck Bonnetain ◽  
Olivier Bouché ◽  
Olivier Chapet ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Toxicity ◽  
Preoperative Radiotherapy ◽  
Rectal Adenocarcinoma ◽  
Digital Rectal Examination ◽  
Concurrent Chemotherapy ◽  
Sphincter Preservation ◽  
Moderate Increase ◽  
Operative Specimen ◽  
Rectal Cancers

Purpose In 1992, preoperative radiotherapy was considered in France as the standard treatment for T3-4 rectal cancers. The present randomized trial compares preoperative radiotherapy with chemoradiotherapy. Patients and Methods Patients were eligible if they presented a resectable T3-4, Nx, M0 rectal adenocarcinoma accessible to digital rectal examination. Preoperative radiotherapy with 45 Gy in 25 fractions during 5 weeks was delivered. Concurrent chemotherapy with fluorouracil 350 mg/m2/d during 5 days, together with leucovorin, was administered during the first and fifth week in the experimental arm. Surgery was planned 3 to 10 weeks after the end of radiotherapy. All patients should receive adjuvant chemotherapy with the same fluorouracil/leucovorin regimen. The primary end point of the trial was overall survival. Results A total of 733 patients were eligible. Grade 3 or 4 acute toxicity was more frequent with chemoradiotherapy (14.6% v 2.7%; P < .05). There was no difference in sphincter preservation. Complete sterilization of the operative specimen was more frequent with chemoradiotherapy (11.4% v 3.6%; P < .05). The 5-year incidence of local recurrence was lower with chemoradiotherapy (8.1% v 16.5%; P < .05). Overall 5-year survival in the two groups did not differ. Conclusion Preoperative chemoradiotherapy despite a moderate increase in acute toxicity and no impact on overall survival significantly improves local control and is recommended for T3-4, N0-2, M0 adenocarcinoma of the middle and distal rectum.

scholarly journals Excision of the Levator Muscles With External Sphincter Preservation in the Treatment of Selected Low T4 Rectal Cancers

2002 ◽  
Vol 45 (12) ◽  
pp. 1697-1705 ◽  
Author(s):  
Claudio Fucini ◽  
Claudio Elbetti ◽  
Alessandra Petrolo ◽  
Donato Casella
Keyword(s):  
External Sphincter ◽  
Sphincter Preservation ◽  
Rectal Cancers
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