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Multivisceral resections for primary advanced rectal cancer
1Colorectal Unit, Department of Surgery, Dokuz Eylül University, School of Medicine, TR-35340 Izmir, Turkey.
International Journal of Colorectal Disease
|February 9, 2000
Summary
Extended surgery for locally advanced rectal cancer is safe and improves resectability. Tumor fixation does not always mean incurability, supporting radical en bloc resection for better outcomes.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Rectal Cancer Research
Background:
- Fixation of locally advanced rectal tumors is a key prognostic factor.
- Distinguishing inflammatory adhesions from direct tumor invasion is challenging.
- Extended en bloc resection improves resectability in advanced rectal cancer.
Purpose of the Study:
- To evaluate perioperative outcomes and prognosis in patients undergoing multivisceral resections for advanced rectal cancers.
- To assess the impact of histologically confirmed carcinomatous invasion versus inflammatory adhesions on outcomes.
Main Methods:
- Retrospective analysis of 83 rectal cancer patients, with 20 having locally advanced tumors (Gunderson-Sosin stages B(3) and C(3)).
- Stratification based on histopathological confirmation of adjacent organ invasion versus inflammatory adhesions.
- Evaluation of perioperative mortality, morbidity, and survival rates.
Main Results:
- Multivisceral resections were performed with a 5% perioperative mortality rate.
- Only 24% of cases showed histopathological confirmation of carcinomatous adhesion.
- No significant survival difference was observed between patients with and without confirmed malignant spread.
Conclusions:
- Multivisceral resection is a safe and effective approach for locally advanced rectal cancers.
- Local tumor extension does not preclude curative intent; radical resection is vital.
- Surgical judgment to extend resection for tethered lesions improves outcomes.