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Open Access 01-10-2020 | Rectal Cancer | Original Article

Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer

Authors: G. Sun, Z. Lou, H. Zhang, G. Y. Yu, K. Zheng, X. H. Gao, R. G. Meng, H. F. Gong, E. J. B. Furnée, C. G. Bai, W. Zhang

Published in: Techniques in Coloproctology | Issue 10/2020

Abstract

Background

Conformal sphincter preservation operation (CSPO) is a new surgical procedure for very low rectal cancers (within 4–5 cm from the anal verge). CSPO preserves more of the dentate line and distal rectal wall and also avoids injuring nerves in the intersphincteric space, resulting in satisfactory anal function after resection. The aim of this study was to analyze the short-term surgical results and long-term oncological and functional outcomes of CSPO.

Methods

Consecutive patients with very low rectal cancer, who had CSPO between January 2011 and October 2018 at Changhai Hospital, Shanghai were included. Patient demographics, clinicopathological features, oncological outcomes and anal function were analyzed.

Results

A total of 102 patients (67 men) with a mean age of 56.9 ± 10.8 years were included. The median distance of the tumor from the anal verge was 3 (IQR, 3–4) cm. Thirty-five patients received neoadjuvant chemoradiation (nCRT). The median distal resection margin (DRM) was 0.5 (IQR, 0.3–0.8) cm. One patient had a positive DRM. All circumferential margins were negative. There was no perioperative mortality. The postoperative complication rate was 19.6%. The median duration of follow-up was 28 (IQR, 12–45.5) months. The local recurrence rate was 2% and distant metastasis rate was 10.8%. The 3-year overall survival and disease-free survival rates were 100% and 83.9%, respectively. The mean Wexner incontinence and low anterior resection syndrome scores 12 months after ileostomy reversal were 5.9 ± 4.3, and 29.2 ± 6.9, respectively.

Conclusions

For patients with very low rectal cancers, fecal continence can be preserved with CSPO without compromising oncological results.

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Title: Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer
Authors: G. Sun
Z. Lou
H. Zhang
G. Y. Yu
K. Zheng
X. H. Gao
R. G. Meng
H. F. Gong
E. J. B. Furnée
C. G. Bai
W. Zhang
Publication date: 01-10-2020
Publisher: Springer International Publishing
Keywords: Rectal Cancer
Rectal Cancer
Ileostomy
Published in: Techniques in Coloproctology / Issue 10/2020
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-020-02229-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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