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Conference Paper: Impact of multimodality treatment on total mesorectal excision (TME) surgery for very low rectal cancers

TitleImpact of multimodality treatment on total mesorectal excision (TME) surgery for very low rectal cancers
Authors
KeywordsMedical sciences
Surgery
Issue Date2009
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
The 43rd World Congress of the International Society of Surgery: International Surgical Week (ISW 2009), Adelaide, Australia, 6-10 September 2009. In World Journal of Surgery, 2009, v. 33 n. 1 suppl., p. S79, abstract no. 0205 How to Cite?
AbstractINTRODUCTION: This study reviews the impact of multimodality treatment of either pre-operative, or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME) surgery for very low rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection (APR). Results of peri-operative and oncological outcomes of patients will be reviewed from a single institution. MATERIAL AND METHODS: 180 consecutive patients with very low rectal adenocarcinomas within 4 cm from anal verge, who underwent elective TME surgery from 1994 to 2007, were retrospectively analysed. Patients were compared in groups that had surgery only (Grp A), pre-operative chemoradiotherapy then surgery (Grp B), and adjuvant therapy post-operative (Grp C). Dependant variables related to patients, treatments, radiotherapy and tumour were analysed. RESULTS: Over 13 years, there were 180 patients in the prospectively collected database that had very low rectal cancer that required either peranal coloanal anastomosis or abdomino-perineal resection (APR). There were 115 males and 65 female with a mean age of 65.43 years (range 30-89). 134 of them underwent an APR while 46 had a sphincter-preserving ultra-low anterior resection with peranal coloanal anastomosis, combined with defunctioning stomas (40 ileostomies and 6 colostomies). 38 of the surgeries were laparoscopically performed. The cohort had a mean follow-up period of 52.98 months (range: 0.57 to 178.9). 69 patients underwent surgery only, while 58 patients received pre-operative chemoradiotherapy, and 53 patients had post-operative adjuvant therapy in addition to surgery. 9 out of the 58 patients with preoperative chemoradiotherapy could go on to have sphincter-saving rectal resection. The overall peri-operative complication rate was 43.4% in Grp A vs. 29.3% in Grp B vs. 39.6% in Grp C. The local recurrence rate was significantly lower in Grp B (6.9% vs. 21.7% in Grp A vs. 33.9% in GrpC). The overall 30-day mortality was 0.56%(1 patient had small bowel gangrene from Grp A) CONCLUSIONS: Pre-operative chemo radiation in patients with low rectal cancer treated with surgery is not associated with a higher incidence of peri-operative complications. lts benefits may include a higher rate of sphincter-preservation surgery and reduction of local recurrence rate.
DescriptionFree Paper (Oral) - Session 74.04
Specific Field: Colon and Rectum
This journal suppl. entitled: International Surgical Week ISW 2009: abstract book of ISW 2009
Persistent Identifierhttp://hdl.handle.net/10722/108262
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375

 

DC FieldValueLanguage
dc.contributor.authorLim, YKen_HK
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorPoon, Jen_HK
dc.contributor.authorFan, JKMen_HK
dc.date.accessioned2010-09-26T00:32:15Z-
dc.date.available2010-09-26T00:32:15Z-
dc.date.issued2009en_HK
dc.identifier.citationThe 43rd World Congress of the International Society of Surgery: International Surgical Week (ISW 2009), Adelaide, Australia, 6-10 September 2009. In World Journal of Surgery, 2009, v. 33 n. 1 suppl., p. S79, abstract no. 0205-
dc.identifier.issn0364-2313-
dc.identifier.urihttp://hdl.handle.net/10722/108262-
dc.descriptionFree Paper (Oral) - Session 74.04-
dc.descriptionSpecific Field: Colon and Rectum-
dc.descriptionThis journal suppl. entitled: International Surgical Week ISW 2009: abstract book of ISW 2009-
dc.description.abstractINTRODUCTION: This study reviews the impact of multimodality treatment of either pre-operative, or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME) surgery for very low rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection (APR). Results of peri-operative and oncological outcomes of patients will be reviewed from a single institution. MATERIAL AND METHODS: 180 consecutive patients with very low rectal adenocarcinomas within 4 cm from anal verge, who underwent elective TME surgery from 1994 to 2007, were retrospectively analysed. Patients were compared in groups that had surgery only (Grp A), pre-operative chemoradiotherapy then surgery (Grp B), and adjuvant therapy post-operative (Grp C). Dependant variables related to patients, treatments, radiotherapy and tumour were analysed. RESULTS: Over 13 years, there were 180 patients in the prospectively collected database that had very low rectal cancer that required either peranal coloanal anastomosis or abdomino-perineal resection (APR). There were 115 males and 65 female with a mean age of 65.43 years (range 30-89). 134 of them underwent an APR while 46 had a sphincter-preserving ultra-low anterior resection with peranal coloanal anastomosis, combined with defunctioning stomas (40 ileostomies and 6 colostomies). 38 of the surgeries were laparoscopically performed. The cohort had a mean follow-up period of 52.98 months (range: 0.57 to 178.9). 69 patients underwent surgery only, while 58 patients received pre-operative chemoradiotherapy, and 53 patients had post-operative adjuvant therapy in addition to surgery. 9 out of the 58 patients with preoperative chemoradiotherapy could go on to have sphincter-saving rectal resection. The overall peri-operative complication rate was 43.4% in Grp A vs. 29.3% in Grp B vs. 39.6% in Grp C. The local recurrence rate was significantly lower in Grp B (6.9% vs. 21.7% in Grp A vs. 33.9% in GrpC). The overall 30-day mortality was 0.56%(1 patient had small bowel gangrene from Grp A) CONCLUSIONS: Pre-operative chemo radiation in patients with low rectal cancer treated with surgery is not associated with a higher incidence of peri-operative complications. lts benefits may include a higher rate of sphincter-preservation surgery and reduction of local recurrence rate.-
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/-
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectMedical sciences-
dc.subjectSurgery-
dc.titleImpact of multimodality treatment on total mesorectal excision (TME) surgery for very low rectal cancersen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.emailPoon, J: tcjensen@hku.hken_HK
dc.identifier.emailFan, JKM: drjoefan@hku.hk-
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.identifier.doi10.1007/s00268-009-0165-5-
dc.identifier.hkuros169252en_HK
dc.identifier.volume33-
dc.identifier.issue1 suppl.-
dc.identifier.spageS79, abstract no. 0205-
dc.identifier.epageS79, abstract no. 0205-
dc.publisher.placeUnited States-

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