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World Journal of Surgery
Published in: World Journal of Surgery 2/2009

01-02-2009

Surgical Outcome of Abdominoperineal Resection for Low Rectal Cancer in a Nigerian Tertiary Institution

Authors: Olusegun I. Alatise, Oladejo O. Lawal, Abdulrasheed K. Adesunkanmi, Stephen A. Osasan

Published in: World Journal of Surgery | Issue 2/2009

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Abstract

Background

Rectal cancer is a lifestyle-related illness with an increasing incidence in all developing countries in the last decade. Abdominoperineal resection (APR) offers a good oncologic clearance for low rectal cancer. The remaining controversies surrounding APR, as it is performed in a tertiary center in Nigeria, involve defining the role the operation plays in the management of existing rectal problems and determining what outcomes can be expected. The present study was aimed at examining the surgical outcomes of APR for low rectal cancers in a Nigerian tertiary institution.

Materials and methods

This single-institution, retrospective, descriptive study analyzed APR rate, patient sex and age, subsite involvement, the diagnostic process, follow-up, and survival patterns after treatment of low rectal cancers. The study was conducted at Obafemi Awolowo University Teaching Hospital Complex Ile-Ife, Nigeria, between January 1989 and December 2007.

Results

During the 18-year period, 36 patients underwent APR. This accounts for 24.0% of all patients that had low rectal cancer. The age of the patients ranged from 29 years to 74 years (median: 58.9 years). Most of the patients were 60 years of age or older, and the majority were women (55.9%). The median duration of symptoms was 12 months, and all patients sought medical care for bleeding per rectum. Close to 80% of patients had advanced disease at presentation. Postoperatively, 17 patients (50%) had at least one complication and one patient (2.9%) died. Four (11.8%) patients had recurrence of the tumor, and in every case, recurrence occurred within the first year after operation. Operative blood loss (p = 0.006), degree of differentiation of the tumor (p = 0.011), distance from the anal verge (p = 0.033), and operative stage (p = 0.005) were found to significantly affect the outcome of treatment for the patients who underwent APR. The operative stage similarly affected the survival of patients (Mantel Cox = 0.026).

Conclusions

Despite the advanced disease of our patients, the outcome of management appears to be comparable with results reported from other centers.
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Metadata
Title
Surgical Outcome of Abdominoperineal Resection for Low Rectal Cancer in a Nigerian Tertiary Institution
Authors
Olusegun I. Alatise
Oladejo O. Lawal
Abdulrasheed K. Adesunkanmi
Stephen A. Osasan
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 2/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-008-9817-0

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