title: Multivisceral resection for advanced rectal cancer: outcomes and experience at a single institution.
abstract: BACKGROUND
  Multivisceral resection is often required in the treatment of locally advanced rectal cancers. Such resections are relatively rare and oncologic outcomes, especially when sphincter preservation is performed, are not fully demonstrated.
  
  
  METHODS
  A retrospective review was conducted of patients who underwent multivisceral resection for locally advanced rectal cancer with and without sphincter preservation.
  
  
  RESULTS
  Sixty-one patients underwent multivisceral resection for rectal cancer from 2005 to 2013 with a median follow-up of 27.8 months. Five-year overall and disease-free survival were 49.2% and 45.3%, respectively. Thirty-four patients (55.7%) had sphincter-sparing operations with primary coloanal anastomosis and temporary stoma. There was no significant difference in overall or disease-free survival, or recurrence with sphincter preservation compared with those with permanent stoma.
  
  
  CONCLUSIONS
  Multivisceral resection for locally advanced rectal cancer has acceptable oncologic and clinical outcomes. Sphincter preservation and subsequent reestablishment of gastrointestinal continuity does not impact oncologic outcomes and should be considered in many patients.
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA. Electronic address: benjamin.crawshaw@uhhospitals.org.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Crawshaw
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Knut M
authors.initials: KM
authors.lastname: Augestad
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Keller
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Nobel
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Swendseid
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Champagne
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Stein
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Conor P
authors.initials: CP
authors.lastname: Delaney
authors.affiliation: Department of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Harry L
authors.initials: HL
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009820:Ohio / Q000453:epidemiology; D010388:Pelvis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014781:Viscera / Q000601:surgery*
keywords: Colorectal cancer; Multivisceral resection; Pelvic exenteration; Rectal cancer