Sphincter-preserving transabdominal-anal radical resection of middle-lower rectal cancer by mucosa-mucosa coloanal anastomosis / 中国普通外科杂志

ABSTRACT

Objective To evaluate the safety and feasibility of sphincter-preserving transabdominal-anal excision of middle-lower rectal cancer by mucosa-mucosa coloanal anastomosis. Methods There were 169 cases undergoing this procedure including 107 males and 62 females. The low margins of the tumors located between 5~9 cm from the anal verge. Histopathological examination showed adenocarcinoma in 163 cases, mucinous adenocarcinoma in 6, and adenoma with canceration in 6.According to Dukes′ classification,61 belonged to Dukes′ A,101 Dukes′B, and 7 Dukes′C. Results Postoperative complications included stomal leak in 5 cases, stomal stenosis in 3, and defecation frequency increased to 6～12 times daily in all cases during the early stage and gradually back to normal 12～18 weeks postoperation. An average follow-up of 5.8 years was made in 154 cases(91.1%).Local recurrence was 5.8%.Hepatic metastasis was 13.7%.The five year survival rate was 66.9%. Conclusion This anal-sphincter preserving procedure while fulfilling radical resection for middle-lower rectal carcinoma is both safe and feasible alternative approach.