W L Law1, K W Chu. 1. Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong. lawwl@hkucc.hku.hk
Abstract
BACKGROUND: The aim of this study was to compare the operative results and oncological outcomes of patients who had mid or distal rectal cancer treated by abdominoperineal resection (APR) with those treated without sphincter ablation (non-APR). METHODS: Five hundred and four consecutive patients (308 men and 196 women) with rectal cancer within 12 cm from the anal verge underwent radical resection with curative intent. Sharp mesorectal dissection was used. Operative results and long-term outcomes were compared between those treated by APR and those by non-APR. RESULTS: Sixty-nine patients had APR and 435 patients were treated with radical resection without perineal resection (anterior resection, 419; Hartmann's operation, 16). The overall operative mortality and morbidity rates were 1.6 and 31.0 per cent respectively. Age, sex, duration of surgery, blood loss, duration of hospital stay, operative mortality and overall morbidity were similar in the two groups. Local recurrence was more frequent after curative APR than after non-APR (23 versus 10.2 per cent at 5 years; P = 0.010). Five-year cancer-specific survival rates after APR and non-APR were 60 and 74.0 per cent respectively (P = 0.006). APR was an independent factor for poor cancer-specific survival in multivariate analysis. CONCLUSION: Although postoperative mortality and morbidity rates were similar in patients with or without sphincter ablation, local control and survival were worse in those treated by APR. Copyright (c) 2004 British Journal of Surgery Society Ltd
BACKGROUND: The aim of this study was to compare the operative results and oncological outcomes of patients who had mid or distal rectal cancer treated by abdominoperineal resection (APR) with those treated without sphincter ablation (non-APR). METHODS: Five hundred and four consecutive patients (308 men and 196 women) with rectal cancer within 12 cm from the anal verge underwent radical resection with curative intent. Sharp mesorectal dissection was used. Operative results and long-term outcomes were compared between those treated by APR and those by non-APR. RESULTS: Sixty-nine patients had APR and 435 patients were treated with radical resection without perineal resection (anterior resection, 419; Hartmann's operation, 16). The overall operative mortality and morbidity rates were 1.6 and 31.0 per cent respectively. Age, sex, duration of surgery, blood loss, duration of hospital stay, operative mortality and overall morbidity were similar in the two groups. Local recurrence was more frequent after curative APR than after non-APR (23 versus 10.2 per cent at 5 years; P = 0.010). Five-year cancer-specific survival rates after APR and non-APR were 60 and 74.0 per cent respectively (P = 0.006). APR was an independent factor for poor cancer-specific survival in multivariate analysis. CONCLUSION: Although postoperative mortality and morbidity rates were similar in patients with or without sphincter ablation, local control and survival were worse in those treated by APR. Copyright (c) 2004 British Journal of Surgery Society Ltd
Authors: Angelita Habr-Gama; Guilherme P São Julião; Adrian Mattacheo; Luiz Felipe de Campos-Lobato; Edgar Aleman; Bruna B Vailati; Joaquim Gama-Rodrigues; Rodrigo Oliva Perez Journal: World J Surg Date: 2017-08 Impact factor: 3.352
Authors: Yon Kuei Lim; Wai Lun Law; Rico Liu; Jensen T C Poon; Joe F M Fan; Oswens S H Lo Journal: World J Surg Oncol Date: 2010-03-26 Impact factor: 2.754