These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Treatment of low rectal cancer by conservative rectal resection after preoperative irradiation. Long term results and prospective study].
    Author: Gouillat C, Bérard P, Chavatte PY, Ain JF, Manganas D.
    Journal: Gastroenterol Clin Biol; 1999; 23(8-9):817-23. PubMed ID: 10533132.
    Abstract:
    AIMS: A prospective study was undertaken to assess the feasibility and long term results of sphincter-preserving rectal excision after preoperative radiation (35 Gy). PATIENTS AND METHODS: From 1986 to 1990, 42 patients were included in the study. Thirty four (81%) could be managed by rectal excision and stapled coloanal anastomosis. They had an adenocarcinoma located at a mean distance of 55 +/- 13 mm (range: 20-80) from the anal verge. RESULTS: Eight specimens were free of tumor. The 26 others were tabulated as follows according to the Astler-Coller staging: A = 2, B1 = 15, B2 = 5, C1 = 1, C2 = 3. The mean distal free margin was 16 +/- 11 mm (range: 1-40). The follow-up period ranged from 5 to 9 years. Six patients (18%) experienced postoperative complications including minor anastomotic leakage (n = 3), bowel obstruction (n = 2), major diarrhea requiring fecal diversion (n = 1). The functional result was good in all but 3 patients (9%) who experienced a supra anastomotic stenosis and underwent a permanent colostomy. A pelvic recurrence was observed in 5 patients (15%) after a postoperative delay ranging from 11 to 50 months. At 5 years, 17 patients (50%) were alive free of cancer, 14 (41%) of them having a good functional result without colostomy. CONCLUSION: This work demonstrates that in most cases low rectal carcinoma can be safely managed by sphincter-preserving rectal excision after preoperative radiation. It strongly suggests that the long-term pelvic recurrence rate is similar to the one observed after abdomino-perineal excision. However both procedures and patients selection must be carefully performed.
    [Abstract] [Full Text] [Related] [New Search]