Sphincter-saving surgeries for rectal cancer: A single center study from Kashmir.
BACKGROUND
The goals in the treatment of rectal cancer are cure, local control, and preservation of sphincter, bladder and sexual function. Surgical resection using sharp mesorectal dissection is important for achieving these goals.


OBJECTIVE
The current treatment of choice for carcinoma rectum is sphincter saving procedures, which have practically replaced the previously done abdominoperineal resection. We performed a study in our institute to evaluate the surgical outcome and complications of rectal cancer.


METHODS
This prospectivestudy included 117 patients, treated for primary rectal cancer by low anterior resection (LAR) from May 2007 to December 2010. All patients underwent standard total mesorectal excision (TME) followed by restoration of continuity.


RESULTS
The peri-operative mortality rate was 2.5% (3/117). Post-operative complications occurred in 32% of the patients. After a median follow up of 42 months, local recurrences developed in 6 (5%) patients and distant metastasis in 5 (4.2%). The survival rate was 93%.


CONCLUSIONS
The concept of total mesorectal excision (TME), advances in stapling technology and neoadjuvant therapy have made it possible to preserve the anal sphincter in most of the patients. Rectal cancer needs to be managed especially in a specialized unit for better results.
Department of General and Minimal Access Surgery, Colorectal Division, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Shabeer Ahmed
SA
Mir
Department of General and Minimal Access Surgery, Colorectal Division, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Nisar A
NA
Chowdri
Department of General and Minimal Access Surgery, Colorectal Division, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Fazl Q
FQ
Parray
Department of Otorhinolaryngology, SMHS Hospital, Srinagar, Jammu and Kashmir, India.
Parvez Ahmed
PA
Mir
Department of Internal Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Yasir
Y
Bashir
Department of General and Minimal Access Surgery, Colorectal Division, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Muntakhab
M
Nafae
Carcinoma rectum; low anterior resection; sphincter saving procedure; total mesorectal excision