Anoabdominal rectal resection and colonic J pouch-anal anastomosis: 10 years' experience.
BACKGROUND
Coloanal anastomosis and radiotherapy for the treatment of lower rectal carcinoma have been receiving increasing attention.


METHODS
Patients with rectal cancer were divided into two groups: anoabdominal rectal resection and colonic J pouch-anal anastomosis (CAA) plus preoperative intraluminal brachytherapy (IBT) (group 1; 68 patients) and CAA without IBT (group 2; 23 patients). Group 3, comprising 59 patients who underwent abdominoperineal excision (APE), was examined as a control group. Comparative results were reviewed.


RESULTS
Postoperative complications occurred more frequently in group 1 than in group 2. Actuarial 5-year survival rates were 73 per cent in group 1, 64 per cent in group 2 and 63 per cent in group 3. Cumulative local recurrence rates at 5 years were 11 per cent in group 1, 38 per cent in group 2 and 21 per cent in group 3. Intestinal continuity breakdown was seen in 14 per cent of all patients at 5 years after initial operation.


CONCLUSIONS
The combination of CAA and preoperative IBT resulted in decreased local recurrence. IBT followed by CAA can be a good restorative option for combating lower rectal cancer.
Kusunoki
M
M
Second Department of Surgery, Hyogo College of Medicine, Japan.
Yanagi
H
H
Shoji
Y
Y
Yamamura
T
T
Utsunomiya
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D001918:Brachytherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012004:Rectal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome