Clinical study of 208 cases of resection of mid-lower rectal cancer with colorectal telescopic mucosa anastomosis to preserve anus / 解放军医学杂志

ABSTRACT

Objective To study the clinical efficacy of colorectal mucosa anastomosis in resection of mid-lower rectal cancer to preserve the anus. Methods A retrospective analysis was carried out with 208 cases of mid-lower rectal cancer operated with the said surgical procedure, including 131 males and 77 females, aged 21-99 years with mean age of 53.7 years. The low margins of the tumors were located 6-8 cm from the anal verge. Pathologically, adenocarcinoma accounted for 201 cases, in whom 86 well-differentiated, 100 moderately differentiated, and 8 poorly differentiated, 7 mucinous adenocarcinoma, and 7 adenoma with malignant degeneration. According to Dukes classification, 76 belonged to Dukes′ A, 122 Dukes′ B, and 10 Dukes′ C. Results 182 cases (87.5%) were followed up, the median follow-up time was 5.9 years. Postoperative complications included 8 cases (3.4%) of stoma leak, and 3 cases (1.7%) of stoma stenosis. The defecation function recovered after 12-24 weeks postoperatively, with frequency of 1-3 times each day. Local recurrence was 4.9% (9/182). Hepatic metastasis was 14.2% (26/182). The five year survival rate was 72.5%. Conclusion Colorectal mucosa anastomosis is safe and efficacious for rectal cancer. With the procedure, the anal function can be preserved well, the incidence of stoma leak is decreased, and the 5 year survival rate is the same as that of Miles operation.