title: Rectal cancer treatment in a teaching hospital.
abstract: BACKGROUND
  Rectal adenocarcinomas surgery morbidity and mortality might be impaired by neoadjuvant therapy. We performed this retropsective study to be compared with the PROCARE study running afterwards.
  
  
  METHODS
  We performed a retrospective study of 95 patients operated on for rectal adenocarcinoma in a single institution during the period of 2007-2009. We used logistic regression to estimate the relationship between possible predictive parameters of anastomotic leakage (AL).
  
  
  RESULTS
  The laparoscopic approach is favored in 63.1% of the cases with a conversion rate of 11.6%, mainly in man (6 out of 7). For low rectal cancer though, laparotomy was the first choice (92.3%). From a carcinological point of view, laparoscopy allowed a complete tumor resection according to the PME (n = 27) and TME (n = 26) standards. Multivariate analysis revealed that women, lower BMI, lower rectum tumor, laparoscopic surgery, neoadjuvant treatment and anal suture were associated with higher risk of AL. The mean hospital stay was 15.4 days (3-46 days) with an in-hospital mortality rate of 3.1%. Adjuvant chemotherapy was completed in 42.1% of the patients. Despite these treatments, we registered a recurrence rate of 26.6%. Of these, 72% were distally localized and 12% exclusively locally. Among the patients operated on by laparoscopy, there was one local recurrence and one local with distant metastases (3.7%). The one- and three-year survival rates were 91.5% and 80.4%, respectively.
  
  
  CONCLUSIONS
  Our study showed a higher rate of AL than expected (18%). In our series recorded in PROCARE-Home, our leak rate has dropped to 10%. It may be indicating a positive effect of PROCARE.
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Verdin
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Joseph
authors.initials: J
authors.lastname: Weerts
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Francart
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Constant
authors.initials: C
authors.lastname: Jehaes
authors.affiliation: b Department of Education , University of Liege , Liège , Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Magis
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Magotteaux
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Laurine
authors.initials: L
authors.lastname: Mattart
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Benoit
authors.initials: B
authors.lastname: Monami
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Christian
authors.initials: C
authors.lastname: Wahlen
authors.affiliation: a Department of Abdominal Surgery , CHC Liege Hospital Center , Liège , Belgium.
authors.forename: Serge
authors.initials: S
authors.lastname: Markiewicz
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak; D003131:Combined Modality Therapy; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anastomotic leak; PROCARE; laparoscopic surgery; rectal adenocarcinoma