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Published on: February 12, 2022
Composite abdominosacral resection for recurrent rectal cancer
P M Sagar1, S Gonsalves, R M Heath
1Department of Colon and Rectal Surgery, General Infirmary at Leeds, Leeds, UK. petersagar@aol.com
The British Journal of Surgery
|January 23, 2009
Summary
Composite abdominosacral resection is an effective treatment for locally recurrent rectal cancer involving the sacrum. Achieving an R0 resection significantly improves disease-free survival compared to R1 resection.
Area of Science:
- Surgical Oncology
- Rectal Cancer Research
- Oncologic Imaging
Background:
- Locally recurrent rectal cancer requires en bloc resection of the tumor and adjacent organs for curative potential.
- Composite resection is a viable option for recurrent rectal tumors involving the sacrum.
Purpose of the Study:
- To assess the outcomes of composite abdominosacral resection for recurrent rectal cancer involving the sacrum.
- To evaluate the efficacy of this surgical approach in a challenging clinical scenario.
Main Methods:
- A consecutive series of patients underwent composite abdominosacral resection between 2001 and 2007.
- Preoperative staging utilized computed tomography, magnetic resonance imaging, and positron emission tomography.
- Data were prospectively collected.
Main Results:
- Forty patients underwent the procedure, with sacral division at various levels (S2/3, S3/4, S4/5).
- One perioperative death and 24 complications were recorded.
- An R0 resection was achieved in 20 patients, demonstrating a significantly longer disease-free interval (55.6 months) compared to R1 resection (32.2 months).
Conclusions:
- Composite abdominosacral resection is an effective treatment for locally recurrent rectal cancer involving the sacrum.
- This complex surgical technique offers a curative option for patients with advanced disease.
