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Total mesorectal excision for middle and lower rectal cancer: a single institution experience with 337 consecutive patients.
Piso, Pompiliu; Dahlke, Marc-Hendrik; Mirena, Petrit; Schmidt, Ursula; Aselmann, Heiko; Schlitt, Hans Juergen; Raab, Rudolf; Klempnauer, Juergen.
Afiliação
  • Piso P; Department for Visceral and Transplantation Surgery, Hannover Medical School, Germany. piso.pompiliu@mh-hannover.de
J Surg Oncol ; 86(3): 115-21, 2004 Jun 01.
Article em En | MEDLINE | ID: mdl-15170648
BACKGROUND AND OBJECTIVES: There have been reports on improved prognosis after TME for middle and lower rectal cancer. No prospective randomized studies have yet been performed. This is a large single institution series evaluating its own results of TME. METHODS: This retrospective study analyses data of 337 patients with middle and lower rectal cancer, treated with either curative or palliative intention between 1990 and 1998. RESULTS: Of all patients, 212 had lower rectal and 125 middle rectal carcinomas. The rate of rectal resections with TME was 96%. A total of 223 patients were treated by anterior rectal resection; 92 patients had to undergo abdomino-perineal resection. Ten patients were operated by a Hartmann resection. Postoperative morbidity was 35% with a leakage rate of 9%. Postoperative mortality was 4%. The rate of local recurrence was 8.6%. The 5-year survival rate after curative resection was 69.3%. The multivariate analysis outlined the tumor stage as independent prognostic factor. CONCLUSIONS: In our experience, TME is feasible with acceptable postoperative morbidity and low mortality. The local recurrence rate can be decreased to lower than 10%. The almost 70% 5-year survival rate indicates a clear benefit for the patients. These findings recommend TME as standard procedure for middle and lower rectal cancer.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Períneo / Neoplasias Retais / Reto Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Humans / Middle aged Idioma: En Revista: J Surg Oncol Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Períneo / Neoplasias Retais / Reto Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Humans / Middle aged Idioma: En Revista: J Surg Oncol Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Estados Unidos