Total rectal resection and colo-anal anastomosis with colonic reservoir for low rectal cancer.
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.
Leo
E
E
Division of Surgical Oncology B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
Belli
F
F
Baldini
M T
MT
Vitellaro
M
M
Mascheroni
L
L
Andreola
S
S
Bellomi
M
M
Rebuffoni
G
G
Lombardi
F
F
Audisio
R
R
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