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Minerva Chirurgica 2018 Apr 13

DOI: 10.23736/S0026-4733.18.07755-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Sphincter-saving proctectomy for rectal cancer with transanal tube NO COIL and without ostoma: clinical outcomes, cost effectiveness and quality of life in elderly

Severino MONTEMURRO 1, Michele AMMENDOLA 1, 2 , Gaetano GALLO 1, Roberto ROMANO 2, Antonietta CONDOLUCI 2, Lucia CURTO 2, Stefano DE FRANCISCIS 3, Raffaele SERRA 3, Rosario SACCO 2, Giuseppe SAMMARCO 2

1 Surgery Unit, National Cancer Institute, Research Centre, “Giovanni Paolo II”, Bari, Italy; 2 Clinical Surgery Unit, Department of Medical and Surgery Sciences, University of Catanzaro,“Magna Graecia” Medical School, Catanzaro, Italy; 2 Surgery Unit, National Cancer Institute, Research Centre, “Giovanni Paolo II”, Bari, Italy; 3 Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy


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BACKGROUND: Colorectal cancer is one of the most common invasive cancers, and it is responsible for considerable physical and psychosocial morbidity specially in older patients. However, only few reports focused on quality of life, cost-effectiveness and clinical outcomes of rectal cancer patients undergone to surgery. This retrospective study compares short-term and long- term outcomes in rectal cancer patients with more and less 75 years of age.
METHODS: Four hundred consecutive patients underwent to radical surgery for rectal adenocarcinoma and they were collected in a prospective institutional database and divided into two groups: group 1 (≥ 75 years, n =98); group 2 (<75 years, n=302). Rectal anterior resection (RAR) with sphincter-saving restorative proctectomy and with application of silicone transanal tube NO COIL ® 60-80 mm long, was the only procedure considered. Main clinical and pathological data were assessed and compared.
RESULTS: Statistically significant differences between the two groups were detected regard to comorbidities and the emergency presentation. Overall survival is lower in patients over 75 age, but cancer-related survival is not different between the two groups.
CONCLUSIONS: Although advanced age is associated with higher morbidity and mortality, in our experience, itself is not a contraindication for surgical sphincter-saving proctetomy in rectal cancer patients. The absence of a stoma improve also, in both groups, the cost-effectiveness and the patients quality of life: psychological morbidity, sexuality, levels of anxiety and depression, body image.


KEY WORDS: Rectal cancer - Elderly - Surgery - Outcomes

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Publication History

Article first published online: April 13, 2018
Manuscript accepted: April 10, 2018
Manuscript received: March 29, 2018

Per citare questo articolo

Montemurro S, Ammendola M, Gallo G, Romano R, Condoluci A, Curto L, et al. Sphincter-saving proctectomy for rectal cancer with transanal tube NO COIL and without ostoma: clinical outcomes, cost effectiveness and quality of life in elderly. Minerva Chir 2018 Apr 13. DOI: 10.23736/S0026-4733.18.07755-6

Corresponding author e-mail

michele.ammendola@libero.it