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Declining indications for abdominoperineal resection.

W O Kirwan1, M G O'Riordain, R Waldron

  • 1University Department of Surgery, Regional Hospital, Cork, Ireland.

The British Journal of Surgery
|October 1, 1989
PubMed
Summary
This summary is machine-generated.

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Sphincter preservation in lower rectal cancer surgery led to anterior resection in most patients, with low perioperative complications and acceptable functional outcomes. This approach offers a viable option for rectal cancer treatment.

Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Gastrointestinal Oncology

Background:

  • Rectal cancer surgery traditionally involves abdominoperineal resection, often resulting in permanent stoma.
  • Sphincter preservation techniques aim to improve quality of life by avoiding colostomy.

Purpose of the Study:

  • To evaluate the outcomes of a consistent sphincter preservation policy in patients with lower two-thirds rectal carcinoma.
  • To assess perioperative complications, functional results, and local recurrence rates following anterior resection for rectal cancer.

Main Methods:

  • A retrospective analysis of 126 consecutive patients undergoing surgery for lower rectal cancer.
  • Patients were managed under a policy of consistent sphincter preservation.
  • Data collected included surgical approach (anterior resection vs. abdominoperineal resection), perioperative complications, and long-term follow-up for functional outcomes and recurrence.

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Main Results:

  • Anterior resection was performed in 100 patients (79%), while 22 (17%) underwent abdominoperineal resection.
  • Perioperative complications in the anterior resection group included death (2), clinical leakage (3), pulmonary embolism (5), pelvic hematoma (1), small bowel obstruction (1), and wound sepsis (6).
  • In patients with potentially curative anterior resection and at least 2 years follow-up (n=55), only one local recurrence was observed. Five percent experienced significant continence issues.

Conclusions:

  • Low anterior resection for rectal carcinoma is associated with low perioperative morbidity.
  • Satisfactory functional results and acceptable local recurrence rates can be achieved with sphincter preservation.
  • Sphincter preservation should be considered a standard approach for selected rectal cancer patients.