Outcomes after Total Mesorectal Excision in the Management of Rectal Experience of 150 Patients
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- Category: Vol. 77, June 2009
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Outcomes after Total Mesorectal Excision in the Management of Rectal Experience of 150 Patients,NAZEM M.A. SHAMS, SAMEH ROSHDY, TAMER F. YOUSSEF, MALAK SHAWKY, MOHAMED EL-KENAWY, SAMIR ZIDAN and NEVEIN ABOTOUK
Abstract
Aim: To assess oncological outcomes including local recurrence and cancer- specific survival as well as functional outcomes including urinary and sexual functions in 150 cases of rectal cancer underwent total mesorectal excision (TME).
Patients and Techniques: Patients with mid or low rectal cancer underwent TME with preservation of autonomic pelvic plexus. Oncological and functional outcomes were prospec-tively recorded and analyzed.
Results: A total of 150 patients of middle and lower rectal cancer underwent either APR or LAR with total mesorectal excision and pelvic nerve preservation between 1997 and 2007 were collected. Anastmotic leak was the commonest complication (16.6%). Isolated local pelvic recurrence was 10.6%. The 5-year overall survival and cancer-specific survival rare were 45% and 52% respectively. All patients could void urine spontaneously and no patient became incontinent or went on chronic retention requiring catheterization. Postop-erative urodynamics revealed normal mean maximal urinary flow rate and voided volume in 90% of patients.
Erection was possible in 93%; penetration ability was possible in 69 patients (80%). Doppler US was normal on both sides in 80%.
Conclusions: Advances in rectal cancer surgical techniques allows improving overall survival and quality of life through local control and preservation of sphincter, sexual and urinary function.