Analysis of Super-low Anterior Resection for Rectal Cancer from a Single Center
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  • 作者:Shao-liang Han (1)
    Xian Shen (1)
    Qi-Qiang Zeng (1)
    Sheng-chong Guo (1)
    Jun Cheng (1)
    Guan-Bao Zhu (1)
  • 关键词:super ; lower anterior resection ; survival ; sexual dysfunction ; fecal dysfunction
  • 刊名:Journal of Gastrointestinal Cancer
  • 出版年:2010
  • 出版时间:September 2010
  • 年:2010
  • 卷:41
  • 期:3
  • 页码:159-164
  • 全文大小:138KB
  • 参考文献:1. Tytherleigh MG, McC Mortensen NJ. Options for sphincter preservation in surgery for low rectal cancer. Br J Surg. 2003;90:922-3. CrossRef
    2. Kishimoto Y, Araki Y, Sato Y, Ogata Y, Shirouzu K. Functional outcome after sphincter excision for ultralow rectal cancer. Int Surg. 2007;92:46-3.
    3. Di Matteo G, Mascagni D, Zeri KP, Torretta A, Di Matteo FM, Maturo A, et al. Evaluation of anal function after surgery for rectal cancer. J Surg Oncol. 2000;74:11-. CrossRef
    4. Kim NK. Recent progress in diagnosis and treatment of rectal cancer (In Korean with English abstract). Korean J Gastroenterol. 2006;47:245-.
    5. Smedh K, Khani MH, Kraaz W, Raab Y, Strand E. Abdominoperineal excision with partial anterior en bloc resection in multimodal management of low rectal cancer: a strategy to reduce local recurrence. Dis Colon Rectum. 2006;49:833-0. CrossRef
    6. Wu XJ, Wang JP, Wang L, et al. Increased rate change over time of a sphincter-saving procedure for lower rectal cancer. Chin Med J (Engl). 2008;121:636-.
    7. Jayne DG, Brown JM, Thorpe H, Walker J, Quirke P, Guillou PJ. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique. Br J Surg. 2005;92:1124-2. CrossRef
    8. Chorost MI, Weber TK, Lee RJ, Rodriguez-Bigas MA, Petrelli NJ. Sexual dysfunction, informed consent and multimodality therapy for rectal cancer. Am J Surg. 2000;179:271-. CrossRef
    9. O’Neil BH, Tepper JE. Current options for the management of rectal cancer. Curr Treat Options in Oncol. 2007;8:331-. CrossRef
    10. Williams NS, Murphy J, Knowles CH. Anterior perineal PlanE for ultra-low anterior resection of the rectum (the APPEAR technique): a prospective clinical trial of a new procedure. Ann Surg. 2008;247:750-. CrossRef
    11. Wang JP, Huang MJ, Song XM, et al. The assessment of curative effect after total mesorectal excision with autonomic nerve preservation for rectal cancer. Zhonghua Wai Ke Za Zhi. 2005;43:1500-.
    12. Aigner F, Trieb T, Ofner D, et al. Anatomical considerations in TNM staging and therapeutical procedures for low rectal cancer. Int J Colorectal Dis. 2007;22:1339-6. CrossRef
    13. Rajput A, Bullard Dunn K. Surgical management of rectal cancer. Semin Oncol. 2007;34:241-. CrossRef
    14. Law WL, Chu KW. Anterior resection for rectal cancer with mesorectal excision: a prospective evaluation of 622 patients. Ann Surg. 2004;240:260-. CrossRef
    15. Sugihara K, Moriya Y, Akasu T, Fujita S. Pelvic autonomic nerve preservation for patients with rectal carcinoma. Oncologic and functional outcome. Cancer. 1996;78:1871-0. CrossRef
    16. Liang JT, Wang SM, Chen KM, Chang KJ. Modified surgical techniques for the superlow anterior resection. Hepatogastroenterology. 1997;44:1331-.
    17. Di Betta E, D’Hoore A, Filez L, Penninckx F. Sphincter saving rectum resection is the standard procedure for low rectal cancer. Int J Colorectal Dis. 2003;18:463-. CrossRef
    18. Dehni N, Cunningham C, Sarkis R, Parc R. Results of coloanal anastomosis for rectal cancer. Hepatogastroenterology. 2000;47:323-.
    19. Secco GB, Fardelli R, Campora E, Rovida S, Bertoglio S. Factors influencing local recurrence after curative surgery for rectal cancer. Oncology. 1989;46:10-. CrossRef
    20. Liu BS, Xu L, Yan J, Liu C, Zheng YC. Experience of ultralow anterior excision for rectal cancer: 508 cases analysis. Zhonghua Wai Ke Za Zhi. 2008 Nov 15;46(22):1712-. PMID: 19094730.
    21. Paty PB, Enker WE, Cohen AM, Minsky BD, Friedlander-Klar H. Long-term functional results of coloanal anastomosis for rectal cancer. Am J Surg. 1994;167:90-. CrossRef
    22. Shah EF, Huddy SP. A prospective study of genito-urinary dysfunction after surgery for colorectal cancer. Colorectal Dis. 2001;3:122-. CrossRef
    23. Nathanson DR, Espat NJ, Nash GM, et al. Evaluation of preoperative and postoperative radiotherapy on long-term functional results of straight coloanal anastomosis. Dis Colon Rectum. 2003;46:888-4. CrossRef
    24. Gamagami R, Istvan G, Cabarrot P, Liagre A, Chiotasso P, Lazorthes F. Fecal continence following partial resection of the anal canal in distal rectal cancer: long-term results after coloanal anastomoses. Surgery. 2000;127:291-. CrossRef
    25. Brown SR, Seow-Choen F. Preservation of rectal function after low anterior resection with formation of a neorectum. Semin Surg Oncol. 2000;19:376-5. CrossRef
    26. Williamson ME, Lewis WG, Finan PJ, Miller AS, Holdsworth PJ, Johnston D. Recovery of physiologic and clinical function after low anterior resection of the rectum for carcinoma: myth or reality? Dis Colon Rectum. 1995;38:411-. CrossRef
    27. Fisher SE, Daniels IR. Quality of life and sexual function following surgery for rectal cancer. Colorectal Dis. 2006;8 Suppl 3:40-. CrossRef
    28. Henry MM, Swash M. Coloproctology and the pelvic Floor. Oxford: Butterworth-Heineman; 1992.
    29. Matsuoka N, Moriya Y, Akasu T, Fujita S. Long-term outcome of urinary function after extended lymphadenectomy in patients with distal rectal cancer. Eur J Surg Oncol. 2001;27:165-. CrossRef
    30. Gutierrez JC, Kassira N, Salloum RM, Franceschi D, Koniaris LG. Surgery for rectal cancer performed at teaching hospitals improves survival and preserves continence. J Gastrointest Surg. 2007;11:1441-. CrossRef
    31. B?hm G, Kirschner-Hermanns R, Decius A, Heussen N, Schumpelick V, Willis S. Anorectal, bladder, and sexual function in females following colorectal surgery for carcinoma. Int J Colorectal Dis. 2008;23:893-00. CrossRef
    32. Kim NK, Aahn TW, Park JK, et al. Assessment of sexual and voiding function after total mesorectal excision with pelvic autonomic nerve preservation in males with rectal cancer. Dis Colon Rectum. 2002;45:1178-5. CrossRef
  • 作者单位:Shao-liang Han (1)
    Xian Shen (1)
    Qi-Qiang Zeng (1)
    Sheng-chong Guo (1)
    Jun Cheng (1)
    Guan-Bao Zhu (1)

    1. Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang Province, China
  • ISSN:1941-6636
文摘
Purpose The purpose of this study was to evaluate the outcome and genitourinary complications of super-low anterior resection (SLAR) followed by adjuvant radiochemotherapy in the management of patients with low rectal cancer. Method One hundred and six low rectal cancer patients managed with SLAR were analyzed retrospectively. Results There were seven patients who failed to follow up, and the 5-year survival rate was 65.7% (65/99). There were 35 patients (35.4%) who developed distant metastases, and 12 (12.1%) had local recurrence. The local recurrence rates were 21.1% (4/19), 7.1% (2/28), 5.9% (1/17), and 0% (0/2) in the patients with tumor distance of less than or equal to 2 cm, ranging from 2.1 to 3.0, from 3.1 to 4.0, from 4.1 to 5.0, and more than 5 cm, respectively. This implied local recurrence rate increased against the distance between the lower margin of tumor and resection line. Ninety-eight of 106 rectal patients had complete data of questionnaire: 58 scored 1, 32 scored 2, 7 scored 3, and 1 score 4. This revealed that the fecal function of most patients (91.8%, 90/98) was normal or nearly normal. Twenty-four of 37 males suffered from sexual dysfunction, and among them, eight were impotent (all older than 70?years), and 29 had retrograde ejaculation. Meanwhile, seven of 35 females suffered from sexual problem, 1 had dyspareunia, seven had decreased lubrication, and one had inability to achieve orgasm. Conclusions SLAR followed by adjuvant radiochemotherapy can effectively control local–regional disease and can be one choice of avoiding the functional morbidity of abdominoperineal resection.

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