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Chirurgia 2000 October-December;13(5-6):267-72

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Expectations for functional sphincteric recovery after extended procedures for rectal cancer

Prete F., Caliandro C., Prete F. P., Scoppetta L., Vincenti L., Liguori P.


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Background. An increasing number of locally advanced cancers (LAC) of the rectum and pelvic relapses (PR) have recently been treated with extensive resection (ER) or pelvic exenteration (PE); not always do these operations imply the permanent loss of sphincteric activities. The aim of this retrospective statistical analysis was to estimate the expectations for functional sphincteric recovery after extended procedures for rectal cancer in our LAC and PR series of patients.
Methods. In a total of 578 consecutive cases of rectal cancer treated in the years 1987-1996 we recorded 104 LAC (i.e. T4 Mo) and 89 PR. The excisional operations for these groups of patients were globally 112 (58%): 66 ER and 46 PE. The normal continuity of both the bowel and the urinary tract was restored in 59.8% and 58.8% of the cases, respectively.
Results. Operating mortality (30 d.): 5.3%; global morbility: 32%; local relapses: 8.8% for LAC and 25% for PR. A year after surgery a complete recovery of the anal sphincteric function was observed in 87% of the non-irradiated and in 66% of the irradiated patients (52% with post-surgical RT). The 5-year overall survival was 43%: 53% for LAC and 18% for PR. The average survival was 27 months, higher for LAC (35 mo) compared to PR (20.7 mo).
Conclusions. The present results confirm the increasingly good perspectives for recovery of normal sphincteric (fecal and urinary) functions after extended surgical procedures for rectal cancer.

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