les amputations abdominoperineales pour adenocarcinome du rectum. technque et resultats. Apropos de 45 cas

ABSTRACT

Between 1977 and 1996, 45 patients underwent abdominoperineal resection [APR] for rectal carcinoma. There were 26 males and 19 females, with a mean age of 57,4 +/- 16.4 years. The mean distance from the anal verge was 4.3 cm. Eight of the 45 patients underwent extensive APR because the tumor was fixed to adjacent organs. Operative mortality was 4.4%. Complications occured in 22.2% of patients and were dominated by colostomy complications [4 cases] and sexual dysfunction [5 cases]. Comparing this results to those of the litt‚rature reviews, the authors discuss operative technique of preservation of pelvic innervation, colostomy and different methods of perineal wound management. Appropriate surgical procedure could reduce specific complications and later dysfunction without changing carcinologic results: