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Changes in outcome with sphincter preserving surgery for rectal cancer in Korea, 1991-2000.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2005 Apr; Vol. 31 (3), pp. 242-9. - Publication Year :
- 2005
-
Abstract
- Aim: To report the clinical and oncological data of patients operated on for rectal cancers 3-5 cm from the AV over a 10 year period, including the Sphincter preservation (SP) rate.<br />Methods: We reviewed medical records of 304 patients with rectal cancers 3-5 cm from the AV who underwent surgical resection from January 1991 through December 2000. The 10 years were divided into three periods based on the introduction of new surgical techniques, specifically, ultralow anterior resection (ULAR) with double stapling in March 1994 and ULAR with coloanal anastomosis in April 1997. The rates of SP, complications and patient survival during these periods were compared.<br />Results: The SP rate increased significantly over the 10 years, from 16.4% in period I (January 1991-February 1994), to 53.0% in period II (March 1994-March 1997), to 86.5% in period III (April 1997-December 2000) (p<0.001). Over time, the age of the patients increased (p=0.004), the length of the distal resection margin became shorter (p=0.005), and the rate of lymph node metastasis increased (p=0.016). The factors significantly influencing SP were the period (p<0.001) and the distance from the AV (p<0.001). Over time, morbidity did not increase, and overall and disease free survival rates did not decrease. In contrast, the overall survival of N2 cases significantly increased over time (p=0.0492).<br />Conclusion: Over 10 years, the SP rate in rectal cancers 3-5 cm from the AV was significantly increased by the introduction of the double stapling and coloanal anastomosis techniques. These surgical methods, however, had no effect on morbidity, disease free survival and overall survival rates.
- Subjects :
- Adult
Aged
Anastomosis, Surgical
Disease-Free Survival
Female
Humans
Korea epidemiology
Lymphatic Metastasis
Male
Medical Records
Middle Aged
Rectal Neoplasms pathology
Retrospective Studies
Surgical Staplers
Survival Analysis
Treatment Outcome
Anal Canal surgery
Colon surgery
Rectal Neoplasms surgery
Suture Techniques adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 0748-7983
- Volume :
- 31
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 15780558
- Full Text :
- https://doi.org/10.1016/j.ejso.2004.11.011