Hui-zhong Qiu1, Bin Wu, Guo-le Lin, Yi Xiao. 1. Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. qiuhzpumc@yahoo.com.cn
Abstract
OBJECTIVE: To evaluate the role of transsphincteric surgery in local excision of mid and lower rectal tumors. METHODS: The clinical data of 97 patients with mid and lower rectal tumors underwent transsphincteric surgery from March 1990 to March 2007 were retrospectively analyzed. RESULTS: Ninety-one patients underwent partial proctectomy, and six underwent segmental proctectomy. Postoperative complications included wound infection in 5 (5.2%), fecal fistula in 4 (4.2%). Pathological examination showed rectal villous adenoma in 35 cases, rectal cancer in 50, rectal carcinoid and others in 12. The pathological stages of rectal cancers included Tis stage in 17 cases, T1 in 21, T2 in 7, T3 in 2, T4 in 3. The mean follow-up was 6.4 years (range, 2 months - 16 years). Three patients developed postoperative local recurrence (6.2%). The three- and five-year survival rate was 93.7% and 87.5%, respectively. There was no operation-related mortality, and no patient developed fecal incontinence. CONCLUSIONS: The transsphincteric surgery brings minor invasion, low operative risk and increased chance of sphincter preservation, which is suitable for treatment of mid and lower rectal tumors.
OBJECTIVE: To evaluate the role of transsphincteric surgery in local excision of mid and lower rectal tumors. METHODS: The clinical data of 97 patients with mid and lower rectal tumors underwent transsphincteric surgery from March 1990 to March 2007 were retrospectively analyzed. RESULTS: Ninety-one patients underwent partial proctectomy, and six underwent segmental proctectomy. Postoperative complications included wound infection in 5 (5.2%), fecal fistula in 4 (4.2%). Pathological examination showed rectal villous adenoma in 35 cases, rectal cancer in 50, rectal carcinoid and others in 12. The pathological stages of rectal cancers included Tis stage in 17 cases, T1 in 21, T2 in 7, T3 in 2, T4 in 3. The mean follow-up was 6.4 years (range, 2 months - 16 years). Three patients developed postoperative local recurrence (6.2%). The three- and five-year survival rate was 93.7% and 87.5%, respectively. There was no operation-related mortality, and no patient developed fecal incontinence. CONCLUSIONS: The transsphincteric surgery brings minor invasion, low operative risk and increased chance of sphincter preservation, which is suitable for treatment of mid and lower rectal tumors.