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Curative resection for low rectal adenocarcinoma: abdomino‐perineal vs anterior resection
Author(s) -
Okaro A. C.,
Worthington T.,
Stebbing J. F.,
Broughton M.,
Caffarey S.,
Marks C. G.
Publication year - 2006
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2006.01045.x
Subject(s) - medicine , rectum , anal verge , surgery , colorectal cancer , pathological , adenocarcinoma , resection , cancer
Objective Local recurrence after abdomino‐perineal excision of the rectum for tumours has been reported to occur in up to a third of patients in contrast to 4% after restorative anterior resection. Method Low rectal tumours were defined as tumours within 8 cm of the anal verge and were treated by either stapled low anterior resection (SLAR) or abdomino‐perineal excision of the rectum (APER). One hundred and seventy‐eight patients with tumours in the lower third of the rectum (30% of 591 rectal cancers) underwent surgical resection between 1980 and 2001. Data were collected prospectively; 68 (38%) had SLAR and 110 (62%) had APER with median follow up of approximately 12 years; 54 SLAR (79%) and 76 APER (69%) had curative procedures on clinical and pathological criteria. Results Local and distant recurrence occurred in seven (13%) and eight (15%) patients in the SLAR group and six (8%) and 14 (18%) patients in the APER group, respectively. Overall 5‐year survival was 63% and 60% in the SLAR and APER groups, respectively Conclusion For rectal cancers within 8 cm of the anal verge, both procedures achieved equivalent results measured by low local recurrence rates and overall survival.