Author/Editor		Štor, Zdravko
Title		Usporedba rezultata niske prednje resekcije i abdominoperinealne ekscizije u bolesnika s karcinomom donje trećine rektuma
Type		monografija
Place		Zagreb
Publisher		Sveučilište u Zagrebu, Medicinski fakultet
Publication year		1999
Volume		str. 61
Language		cro
Abstract		Background. Low anterior resection (LAR) is performed with increasing frequency for patients with carcinoma of the lower third of the rectum. Our study compares the LAR and abdominoperineal excision (APE) results in patients with carcinoma of the lower third of the rectum. Patients and methods. In the period from 1.1.1989 to 31.12.1995 116 patients with carcinoma of tlže lower third of the rectum underwent potentially curative resection. Five-years survival was estimated with Kaplan-Meier statistical analysis. Patients who died within 30 days after operations were censored. Differences in survival curves between both groups were assessed by the log rank test. Results. We performed LAR in 44 of 116 (37,9%) patients and APE in 53 of 116 (45,7%). In the lower third of the rectum in 52 out of 116 (44,8%) patients we preserved the sphincter (LAR, local excision). The patients were divided according to the type of operation by the Dukes classification: LAR (A11/44 25%; B16/44 36,4%; C17/44 38,6%), APE (Al2/53 22,6%; B17/53 32,1%; 624/53 45,3%). Five-year survival rate for patients with Dukes B and C tumors in the lower third of the rectum is 25% for LAR and 53% for APE. There was no statisticaly significant difference of survival curves between the two operations (pž,20458, Log rank). We analyzed our results with regard to positive lymphatic glands: LAR (N1 15,9%; N2 25%; N3 11,4%); APE (Nl 18,9%; N2 22,6%; N3 0%). Lymphatic spread was found in 23 of 44 (52,3%) of the patients with LAR and in 22 of 53 41,5% of the patients with APE. Anastomotic leakage became clinically manifest in 8 out of 44 patients (18,2%). All the patients required relaparatomy and were treated with temporary loop colostomy. Conclusion. We performed LAR (52,3%) in a higher percentage of patients with lymphatic dissemination than APE (41,5%). Thus the difference in fiveyear survival rate is not surprising: LAR (25%), APE (53%).
Descriptors		RECTAL NEOPLASMS NEOPLASM STAGING COLECTOMY PERINEUM SURVIVAL ANALYSIS PROGNOSIS RADIOTHERAPY, ADJUVANT ANTINEOPLASTIC AGENTS AGE FACTORS