Total anorectal reconstruction supported by electrostimulation gracilis neosphincter.
OBJECTIVE
To review and to update the results of Total Anorectal Reconstruction with Electrostimulated Graciloplasty (ES-TAR) at the same time as or following abdominoperineal resection (APR).


METHODS
A university hospital in Italy.


METHODS
Retrospective study.


METHODS
A series of 98 consecutive anorectal cancer patients who had undergone ES-TAR (in 88 cases at the same time as APR; in 10 cases following APR), 61 of whom are still evaluable in respect of continence (median follow-up period 55 months).


RESULTS
There was no mortality. Thirty-seven percent of patients had postoperative complications with no impact on survival or functional outcome. The 5-year survival rate in 50 patients was 61% and the 5-year estimated cumulative probability of survival in 81 patients was 65%. Local recurrence rate was 16%. Continence was achieved in 87% of patients with a chronically stimulated TAR, and in 69% of patients with short-term stimulation.


CONCLUSIONS
ES-TAR is a safe and effective method for both curing anorectal cancer and restoring continence. It may be considered a reliable alternative to sphincter-saving procedures in lower rectal cancer patients.
Department of Surgery, University of Pisa, S. Chiara Hospital, Italy.
E
E
Cavina
M
M
Seccia
M
M
Chiarugi
D001003:Anal Canal / Q000601:surgery*; D001005:Anus Neoplasms / Q000401:mortality / Q000601:surgery*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D015996:Survival Rate