Comparison of Sphincter Saving Resection (SSR) & Sphincter Losing Abdominoperineal Resection (APR) in Very Low Rectal Cancer

Authors

  • Jawhar Lal Singha Associate Professor (Surgery), Shaheed Suhrawardy Medical College, Dhaka
  • Sami Ahmad Associate Professor (Surgery), Shaheed Suhrawardy Medical College, Dhaka
  • Nadim Ahmed Senior Consultant (Surgery), Shaheed Suhrawardy Medical College, Dhaka
  • ABM Muksudul Alam Professor of Anesthesiology & Principal, Shaheed Suhrawardy Medical College, Dhaka

DOI:

https://doi.org/10.3329/jssmc.v11i1.43170

Keywords:

Sphincter-saving resection, Sphincter Losing resection, Abdominoperineal resection, Oncological outcomes, Recurrence, Preoperative chemo radiotherapy, Rectal cancer.

Abstract

Oncological outcomes of sphincter-saving resection (SSR) and sphincter losing abdominoperineal resection (APR) in 210 consecutive patients with very low-lying rectal cancer (i.e. lower margin of tumor is within 3.5 cm from the anal verge) were studied and compared. 54 (25.71%) patients underwent SSR and 156 (74.28%) patients underwent SLR-APR. The APR group comprised higher proportions of men (61.53% vs 55.5%, P =.049) and advanced-stage disease (P <.001). Preoperative chemoradiotherapy (PCRT) was administered in both the group with almost similar distribution (62.82 % vs 59.25%, P <.001). Overall, (the systemic and local) recurrence rates were almost similar i.e. 33.31% in SSR and 33.32% in APR. On stratification according to PCRT and pathologic stage, the mode of surgery did not affect the recurrence type. Moreover, recurrence-free survival (RFS) did not differ according to the mode of surgery in different cancer stages. Patients who were stratified according to cancer stage and PCRT also showed no differences in RFS according to the mode of surgery. The results of the study demonstrate that, regardless of PCRT administration, SSR is an effective treatment for very low rectal cancer.

J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 3-8

 

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Published

2019-09-17

How to Cite

Singha, J. L., Ahmad, S., Ahmed, N., & Alam, A. M. (2019). Comparison of Sphincter Saving Resection (SSR) & Sphincter Losing Abdominoperineal Resection (APR) in Very Low Rectal Cancer. Journal of Shaheed Suhrawardy Medical College, 11(1), 3–8. https://doi.org/10.3329/jssmc.v11i1.43170

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Section

Original Articles