Abdominoperineal resection for rectal cancer at a specialty center.

摘要: PURPOSE: Although sphincter-preservation procedures have replaced abdominoperineal resection as the treatment of choice for rectal cancer, a subset patients with cancer will still require resection. The use adjuvant radiotherapy has been shown to reduce local recurrence, and combined modality therapy (chemoradiation) improves survival. Sharp mesorectal excision compared classic teaching blunt retrorectal dissection is also an important component control. primary aim present study was evaluate postoperative complications associated neoadjuvant in requiring complete excision. Oncologic outcomes all are provided. METHODS: A prospective database 5,634 who underwent surgery colorectal at Memorial Sloan-Kettering Cancer Center between years 1987 1997 reviewed. Patients adenocarcinoma rectum were identified. In 1,622 operated on 292 (18 percent) rest had sphincter-preserving procedure. Ten excluded from because prior pelvic irradiation other (8 patients) insufficient radiation dose (<4,000 cGy; 2 patients). Neoadjuvant given 123 65 patients, whereas 94 did not receive radiotherapy. Intraoperative preoperative administered 23 RESULTS: duration operation significantly longer both intraoperative groups nonradiotherapy group (P=0.01 andP<0.0001, respectively). Estimated blood loss, mean number units transfused per patient, percentage being similar among groups. Early higher group. Late complications, overall survival, disease-free recurrence different CONCLUSIONS: lower one-third rectum, sharp can result low rate even without role radiotherapy, although perineal wound increasing resectability rate. Randomized, trials be needed establish undergoing cancer.