Sphincter-saving extrasphincteric rectal dissection and proximal segmental sphincteric excision techniques by using combined abdominal and transvaginal anterior perineal access in female patients who have lower rectal cancer ( Transvaginal low anterior rectal resection )

Abstract Objective: Sphincter saving techniques in low rectal cancer represents a challenge for the surgeons in their attempt to preserve the sphincter function and also to respect the principles of oncological surgery, in order to improve the quality of the patient’s life. The paper’s aim is to compare different sphincter saving techniques in regards to the early postoperative results. Methods: An observational, retrospective study was performed on 76 patients (N = 76) operated for low rectal cancer in the Surgical Clinic no.1 of the Targu Mures Emergency Clinical County Hospital, between January 2010 and October 2014, to whom the rectal resection was followed by a primary restorative technique for preservation of the sphincter function. The immediate postoperative results after different types of sphincter saving procedures were analyzed and compared. Results: From the studied patients, in 41 cases (53.94%) an anterior rectal resection with low colorectal anastomosis was done („very low” Dixon procedure), for 29 patients (38.15%) a sphincter saving technique with a peranal anastomosis was performed and in 6 cases (7.89%) an intersphinteric rectal resection with coloanal anastomosis was made. Conclusions: Sphincter saving techniques, if oncological principles are respected, represents a viable option in the treatment of low rectal cancer and brings hope for improving the quality of the patients’ life.

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Risk of Permanent Stoma after Sphincter-Saving Resection for Mid-to-Lower Rectal Cancer

Zeitschrift für Gastroenterologie ◽

10.1055/s-0032-1315850 ◽

2012 ◽

Vol 50 (06) ◽

Author(s):

A Dinnewitzer ◽

T Jäger ◽

T Fitzka ◽

D Öfner

Keyword(s):

Rectal Cancer ◽

Lower Rectal Cancer ◽

Permanent Stoma ◽

Sphincter Saving Resection ◽

Sphincter Saving

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Prediction of anastomotic leakage after anterior rectal resection

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.3.252 ◽

2019 ◽

Vol 35 (3) ◽

Cited By ~ 2

Author(s):

Shubang Cheng ◽

Bolin He ◽

Xueyi Zeng

Keyword(s):

Rectal Cancer ◽

Prediction Model ◽

Anastomotic Leakage ◽

Roc Curve ◽

Rectal Resection ◽

Preoperative Chemoradiotherapy ◽

Tumor Differentiation ◽

Intraoperative Bleeding ◽

Anterior Rectal Resection ◽

Validation Set

Objective: Anastomotic Leakage (AL) is one of the most common complications after resection of rectal cancer. Recognition of the incidence and risk factors related to AL is important. This study aimed develops a model that can predict anastomotic leakage after anterior rectal resection. Methods: Data from 188 patients undergoing anterior resection of rectal cancer were collected for retrospective analysis. Patients were randomly divided in the development set and validation set at a 1:1 ratio. We first included age, sex, preoperative chemoradiotherapy, tumor size, degree of tumor differentiation, stage, TNM stage, lymph vascular invasion, distance, anastomotic method, diabetes, intraoperative time, intraoperative bleeding and smoking as candidates for variable selection with a LASSO method. A ROC curve was constructed with the validation set to assess the accuracy of the prediction model. Results: AL occurred in 20 of 188 patients (10.6%). Preoperative chemoradiotherapy (p=0.04), medium degree of tumor differentiation (p=0.04), anastomotic method (p<0.01), intraoperative bleeding≥400ml (p<0.01), smoking (p<0.01), diabetes (p<0.01) were significantly related to AL. The area under the ROC curve of the prediction model is 0.952. Conclusions: This study developed a model that can predict anastomotic leakage after anterior rectal resection, which may aid the selection of preventive ileostomy and postoperative management. doi: https://doi.org/10.12669/pjms.35.3.252 How to cite this:Cheng S, He B, Zeng X. Prediction of anastomotic leakage after anterior rectal resection. Pak J Med Sci. 2019;35(3):830-835. doi: https://doi.org/10.12669/pjms.35.3.252 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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