Factors determining Sphincter salvage in Laparoscopic Rectal cancer Surgery in a high volume centre:

C Palanivelu, MS, P Senthilnathan, MD, FACS, R Parthasarathi, MS, P Praveen Raj, MS, S Rajapandian, MS, V Vaithiswaran, MS

GEM Hospital

Background:
Laparoscopic rectal cancer surgery is widely performed in specialised centres. The sphincter salvage rate for low rectal tumours has increased remarkably in last two decades. Still, a subset of patients with very low rectal tumours poses unique challenges, which can be met only with expertise, skill and judgement to perform successful sphincter salvage. We analysed the factors contributing to sphincter salvage.

Methodology:
We analysed our prospective database of low rectal cancer patients undergoing Laparoscopic low-anterior, ultralow- anterior and Abdomino perineal resections in last three years. The factors determining sphincter salvage were analysed.

Results:
Of 84 patients who had low rectal tumours, 14 (16.6 %) underwent abdomino-perineal resection. 52(61.9%) patients underwent Low anterior resection and 18 (21.4%) underwent Ultralow-Anterior resection with colo-anal anastomosis. The factors that significantly determined sphincter salvage were age, sex, socio economic status, distance from anal verge, grade and differentiation of tumor, initial stage at presentation and experience of surgeon.

Conclusion:
Various factors contributed to sphincter salvage and except one (experience of surgeon) were patient or tumour factors.

Session: Poster Presentation

Program Number: P127