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Total mesorectal excision for middle and lower rectal cancer: A single institution experience with 337 consecutive patients
Author(s) -
Piso Pompiliu,
Dahlke MarcHendrik,
Mirena Petrit,
Schmidt Ursula,
Aselmann Heiko,
Schlitt Hans Juergen,
Raab Rudolf,
Klempnauer Juergen
Publication year - 2004
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20062
Subject(s) - medicine , total mesorectal excision , colorectal cancer , surgery , rectum , survival rate , stage (stratigraphy) , cancer , paleontology , biology
Background and Objectives There have been reports on improved prognosis after TME for middle and lower rectal cancer. No prospective randomized studies have yet been performed. This is a large single institution series evaluating its own results of TME. Methods This retrospective study analyses data of 337 patients with middle and lower rectal cancer, treated with either curative or palliative intention between 1990 and 1998. Results Of all patients, 212 had lower rectal and 125 middle rectal carcinomas. The rate of rectal resections with TME was 96%. A total of 223 patients were treated by anterior rectal resection; 92 patients had to undergo abdomino‐perineal resection. Ten patients were operated by a Hartmann resection. Postoperative morbidity was 35% with a leakage rate of 9%. Postoperative mortality was 4%. The rate of local recurrence was 8.6%. The 5‐year survival rate after curative resection was 69.3%. The multivariate analysis outlined the tumor stage as independent prognostic factor. Conclusions In our experience, TME is feasible with acceptable postoperative morbidity and low mortality. The local recurrence rate can be decreased to lower than 10%. The almost 70% 5‐year survival rate indicates a clear benefit for the patients. These findings recommend TME as standard procedure for middle and lower rectal cancer. J. Surg. Oncol. 2004;86:115–121. © 2004 Wiley‐Liss, Inc.