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Hand-sewn coloanal anastomosis for distal rectal cancer: Long-term clinical outcomes

Authors
 Seung Hyuk Baik  ;  Nam Kyu Kim  ;  Kang Young Lee  ;  Seung Kook Sohn  ;  Chang Hwan Cho 
Citation
 JOURNAL OF GASTROINTESTINAL SURGERY, Vol.9(6) : 775-780, 2005 
Journal Title
 JOURNAL OF GASTROINTESTINAL SURGERY 
ISSN
 1091-255X 
Issue Date
2005
MeSH
Adult ; Aged ; Anal Canal/surgery* ; Anastomosis, Surgical/methods ; Cohort Studies ; Colectomy/methods ; Disease-Free Survival ; Fecal Incontinence/epidemiology ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Rectal Neoplasms/mortality* ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery* ; Rectum/surgery* ; Retrospective Studies ; Risk Assessment ; Survival Analysis ; Suture Techniques* ; Treatment Outcome
Keywords
Rectal cancer ; hand-sewn coloanal anastomosis ; ultralow anterior resection
Abstract
As the oncologic safety of coloanal anastomosis (CAA) has been proved by many other authors, the incidence of CAA following ultralow anterior resection has increased. The purpose of this study is to evaluate the functional outcome and complications of patients who underwent ultralow anterior resection and CAA for distal rectal cancer. Fifty-seven patients underwent CAA following ultralow anterior resection between July 1997 and November 2003. Forty-four patients, who were followed up more than 6 months after diverting ileostomy closure, were evaluated for recurrence, complications, and functional outcomes. The mean follow-up period was 36.3 ±22.8 months (range, 8–83 months). The complications were multiple fistula (n = 3), fistula with anal stenosis (n = 1), local recurrence with anal stenosis (n =1), and anal stenosis (n =7). Anal incontinence (Kirwan grade III) was noted in 14 patients, and bowel movements were observed more than six times per day in 16 patients. Overall recurrence occurred in six patients (13.6%). The 5-year survival rate was 85.3%, and the disease-free 5-year survival rate was 73.3%. Although CAA in patients with rectal cancer provides excellent long-term survival, a low risk of recurrence, and tolerable function, complications and poor functional outcomes of CAA do occur. Therefore, the choice of this method should be considered carefully.
Full Text
http://link.springer.com/article/10.1016/j.gassur.2005.03.003
DOI
10.1016/j.gassur.2005.03.003
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
Cho, Chang Hwan(조장환)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151225
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