title: Total rectal resection and colo-anal anastomosis with colonic reservoir for low rectal cancer.
abstract: From March 1990 to December 1992, 47 patients with primary or recurrent low rectal cancer underwent total rectal resection and a coloendoanal anastomosis. Rectal resection was extended downward to the ano-rectal junction. The restorative technique included a colo-endoanal anastomosis between the dentate line and a J-shaped colic reservoir. All lesions were located within 7 cm of the anal verge (within 6 cm in 33 primary cases). Macroscopic and histological radicality was documented in all cases. Pelvic recurrence occurred in six patients and was para-anastomotic in one case. Post-operative morbidity was low. Perfect continence was documented in 36 patients and 72 of the cases had one or two bowel movements a day. All but four patients are alive at a follow-up ranging from 6 to 40 months (median 20 months). This approach is a safe option to conventional total rectal excision with permanent colostomy for lower third rectal carcinoma.
authors.affiliation: Division of Surgical Oncology B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Leo
authors.forename: F
authors.initials: F
authors.lastname: Belli
authors.forename: M T
authors.initials: MT
authors.lastname: Baldini
authors.forename: M
authors.initials: M
authors.lastname: Vitellaro
authors.forename: L
authors.initials: L
authors.lastname: Mascheroni
authors.forename: S
authors.initials: S
authors.lastname: Andreola
authors.forename: M
authors.initials: M
authors.lastname: Bellomi
authors.forename: G
authors.initials: G
authors.lastname: Rebuffoni
authors.forename: F
authors.initials: F
authors.lastname: Lombardi
authors.forename: R
authors.initials: R
authors.lastname: Audisio
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000601:surgery*; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000601:surgery*; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome