Surgical treatment of rectal cancer: prospective cohort study about good oncologic results and low rates of abdominoperineal excision.

Autor:	Faier TAS; - Hospital Felicio Rocho - Belo Horizonte - MG - Brasil., Queiroz FL; - Hospital Felicio Rocho - Belo Horizonte - MG - Brasil., Lacerda-Filho A; - Hospital Felicio Rocho - Belo Horizonte - MG - Brasil., Paiva RA; - Hospital Felicio Rocho - Belo Horizonte - MG - Brasil., França Neto PR; - Hospital Felicio Rocho - Belo Horizonte - MG - Brasil., Cortes MGW; - Hospital Biocor - Belo Horizonte - MG - Brasil., Carvalho AR; - Hospital Felicio Rocho - Belo Horizonte - MG - Brasil., Pereira BMT; - Hospital Felicio Rocho - Belo Horizonte - MG - Brasil.
Jazyk:	English; Portuguese
Zdroj:	Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2023 Jul 28; Vol. 50, pp. e20233435. Date of Electronic Publication: 2023 Jul 28 (Print Publication: 2023).
DOI:	10.1590/0100-6991e-20233435-en
Abstrakt:	Objectives: the purpose of this study was to evaluate the outcome of rectal cancer surgery, in a unit adopting the principles of total mesorectal excision (TME) with a high restorative procedure rate and with a low rate of abdominoperineal excision (APE). Methods: we enrolles patients with extraperitoneal rectal cancer undergoing TME or TME+APE. Patients with mid rectal tumors underwent TME, and patients with tumors of the lower rectum and no criteria for APE underwent TME and intersphincteric resection. Those in which the intersphincteric space was invaded and in those with a free distal margin less than 1cm or a tumor free radial margin were unattainable underwent APE or extralevator abdominoperineal excision (ELAPE). We assessed local recurrence rates, overall survival and involvement of the radial margin. Results: sixty (89.6%) patients underwent TME and seven (10.4%) TME + APE, of which five underwent ELAPE. The local recurrence, in pacientes undergoing TME+LAR, was 3.3% and in patients undergoing APE, 14.3%. The local recurrence rate (p=0.286) or the distant recurrence rate (p=1.000) was similar between groups. There was no involvement of radial margins. Survival after 120 months was similar (p=0.239). Conclusion: rectal malignancies, including those located in the low rectum, may be surgically treated with a low rate of APE without compromising oncological principles and with a low local recurrence rates.
Databáze:	MEDLINE
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