Short & middle term results of lower rectal cancer according to procedure.

Toshimasa Ishii, PhD, Shigeki Yamaguchi, Prof. Saitama medical university international medical center

Purpose: Since April 2007 of hospital opening, we tried to perform intersphincteric resection ( ISR ) and laparoscopic resection ( Lap ) for lower rectal cancer. This study was assessed short term results for recent 7 years.

Patients: One hundred fifty-four patients of curative advanced lower rectal cancer laparoscopic resection ( Stage II, III ) were included in this study. There are 107 males and 48 females. Each number of procedure was; low anterior resection ( LAR ) 87, ISR 46, Abdomino-perineal resection ( APR ) 22. Thirty patients received lateral lymphadenectomy. All cases of LAR and ISR had diverting stoma. The mean follow-up length were 934.3 days.

Method: We analyzed retrospectively. Statistical analysis of short term results was performed using Student’s t-test and chisquare test method. 3-years disease free survival rate ( middle term result )  was calculated using Logrank method.

Results: There in no motality and all patients returned to normal daily life after surgery.  Mean operating time, mean blood loss count, and mean postoperative hospital stay ( median ) were LAR 259 min., 22 g, 10 days, ISR 332 min., 76 g, 9 days, APR 283 min., 94 g, 11 days, respectively. Regarding postoperative complication rates, anastomotic leakage, intestinal obstruction, and wound infection were LAR 11.5 %, 13.8 %, 1.1 %, ISR 4.3 %, 8.7 %, 0%, APR -%, 0 %, 22.7 %. There were no difference of postoperative complications between LAR and ISR and APR. But APR were difference of wound infection. There were no difference of 3-years disease free survival rate ( LAR 76.2 %, ISR 69.7 %, APR 81.9 % ).

Conclusion: Short & middle term results of laparoscopic resection for lower rectal cancer in a single center were similar to that each procedure. Laparoscopic resection for lower rectal cancer was usually already operations.

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