scholarly journals Ultralow anterior resection and coloanal anastomosis for distal rectal cancer: functional and oncological results

2001 ◽  
Vol 16 (4) ◽  
pp. 234-237 ◽  
Author(s):  
Nam Kyu Kim ◽  
Dae Jin Lim ◽  
Seong Hyeon Yun ◽  
Seung Kook Sohn ◽  
Jin Sik Min
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Coloanal Anastomosis ◽  
Ultralow Anterior Resection ◽  
Distal Rectal Cancer ◽  
Oncological Results

Ultralow Anterior Resection and Coloanal Anastomosis for Low-Lying Rectal Cancer: An Appraisal Based on Bowel Function

2018 ◽  
Vol 36 (5) ◽  
pp. 409-417 ◽  
Author(s):  
Chinock Cheong ◽  
Seung Yeop Oh ◽  
Soo Jeong Choi ◽  
Kwang Wook Suh
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Old Age ◽  
Anterior Resection ◽  
Coloanal Anastomosis ◽  
Bowel Dysfunction ◽  
Chemoradiation Therapy ◽  
Ultralow Anterior Resection ◽  
Male Sex ◽  
Over Time

Backgrounds/Aims: On the basis of acceptable oncologic results, ultralow anterior resection (ULAR) and colo-anal anastomosis plus hand-sewn coloanal anastomosis have been performed for treating very low-lying rectal cancer. However, many patients experience bowel dysfunction after ULAR. Studies have provided inadequate data on bowel dysfunctions and only a few functional studies have focused on low rectal cancer. Therefore, we aimed to elucidate the severity of bowel dysfunction after ULAR in a single-surgeon cohort. Methods: In this prospective observational study, we analyzed data of 203 patients who underwent sphincter-preserving surgery for low-lying rectal cancer (tumor located within 5 cm from the anus) between January 2011 and December 2014. During routine follow-up, examinations (3–6 months interval) after ileostomy closure, patients were asked about their bowel functions based on the Wexner incontinence and LAR syndrome (LARS) scores. Patients were divided into 2 groups: LAR group (LAR with double-stapled anastomosis) and ULAR group (ULAR with coloanal anastomosis), and functional scores were compared between 6 and 36 months. Seven risk factors for major LARS were analyzed. Results: At 36 months after surgery, 94.2 and 70.6% of patients in the ULAR group still had moderate to severe incontinence and major LARS respectively. Fecal incontinence improved significantly over time (ULAR group, 14.4 vs. 7.2, p = 0.045; LAR group, 13.9 vs. 5.4, p < 0.05). However, improvement in LARS over time was observed in the LAR group only (26.5 vs. 19.7, p = 0.045). In the ULAR group, the difference did not reach a statistical significance (33.6 vs. 26.0, p = 0.10). Major LARS and moderate incontinence were significantly higher in the ULAR group than in the LAR group (70.6 vs. 47.6%, p = 0.001; 82.4 vs. 32.0%, p = 0.012 respectively). Among the 7 factors evaluated in multivariable analysis, old age (> 70), male sex, ULAR per se, and chemoradiation therapy were found to be meaningful risk factors for major LARS. Conclusion: In patients with low rectal cancers undergoing ULAR plus coloanal anastomosis, bowel dysfunctions were severe. Bowel dysfunctions improved over time, but most patients still experienced major bowel dysfunctions even 36 months after surgery. Risk factors for bowel dysfunctions were old age, male sex, adjuvant chemoradiation therapy, and ULAR. Therefore, ULAR should be performed in carefully selected patients with low-lying rectal cancer.

scholarly journals Treatment of Rectal Cancer by Low Anterior Resection with Coloanal Anastomosis

1994 ◽  
Vol 219 (4) ◽  
pp. 365-373 ◽  
Author(s):  
Philip B. Paty ◽  
Warren E. Enker ◽  
Alfred M. Cohen ◽  
Gregory Y. Lauwers
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Coloanal Anastomosis

Hand-Sewn Coloanal Anastomosis for Distal Rectal Cancer: Long-Term Clinical Outcomes

2005 ◽  
Vol 9 (6) ◽  
pp. 775-780 ◽  
Author(s):  
S BAIK ◽  
N KIM ◽  
K LEE ◽  
S SOHN ◽  
C CHO
Keyword(s):  
Rectal Cancer ◽  
Clinical Outcomes ◽  
Coloanal Anastomosis ◽  
Distal Rectal Cancer

6033 POSTER Ultra Low Anterior Resection for Distal Rectal Cancer – the End of the 1CM Rule?

2011 ◽  
Vol 47 ◽  
pp. S401
Author(s):  
W. Ceelen ◽  
Y. Van Nieuwenhove ◽  
D. Vande Putte ◽  
R.J. Elshout ◽  
P. Pattyn
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Distal Rectal Cancer

Long-Term Functional and Quality of Life Outcomes After Coloanal Anastomosis for Distal Rectal Cancer

2006 ◽  
Vol 49 (9) ◽  
pp. 1266-1274 ◽  
Author(s):  
Imran Hassan ◽  
David W. Larson ◽  
Robert R. Cima ◽  
Janette U. Gaw ◽  
Heidi K. Chua ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Coloanal Anastomosis ◽  
Life Outcomes ◽  
Distal Rectal Cancer ◽  
Quality Of Life Outcomes

scholarly journals Intersphincteric Resection and Coloanal Anastomosis in Treatment of Distal Rectal Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Gokhan Cipe ◽  
Mahmut Muslumanoglu ◽  
Erkan Yardimci ◽  
Naim Memmi ◽  
Erhan Aysan
Keyword(s):  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Functional Outcomes ◽  
Coloanal Anastomosis ◽  
Intersphincteric Resection ◽  
Distal Rectal Cancer ◽  
Sphincter Saving ◽  
Resection Line ◽  
Alternative Choice

In the treatment of distal rectal cancer, abdominoperineal resection is traditionally performed. However, the recognition of shorter safe distal resection line, intersphincteric resection technique has given a chance of sphincter-saving surgery for patients with distal rectal cancer during last two decades and still is being performed as an alternative choice of abdominoperineal resection. The first aim of this study is to assess the morbidity, mortality, oncological, and functional outcomes of intersphincteric resection. The second aim is to compare outcomes of patients who underwent intersphincteric resection with the outcomes of patients who underwent abdominoperineal resection.

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