Background. The authors analyze retrospectively a consecutive series of rectal carcinomas operated on with different surgical strategies at Third Surgical Department of "La Sapienza" University of Rome, between January 1985 and December 1997, by one expert surgeon (GDM), and report the incidence of the local recurrence correlated to the surgical technique development. Methods. In most recent groups of patients treated for extraperitoneal neoplasm from January 1992 with curative (RO) total mesorectal excision (TME) and nerve sparing technique (NST) (Group C, n=47) and with curative TME plus lateral pelvic lymphadenectonmy (LPL) and NST (Group D, n=7), sacrificing the pelvic autonomic nervous system only in case of neoplastic infiltration, the local recurrence was 8.5% (4 cases, with mean interval of 30.5 months) and 0 respectively at mean follow-up of 44.9 and 55 months. Results, In none of the local recurrences of the Group C a re-resection (neither curative nor palliative) was possible and the survival was 50% at 14 months from the diagnosis of relapse, Instead, in local recurrences of rectal carcinoma in patients who underwent a first anterior resection with less extended dissection in other Department (Group E), a re-resection was possible for 3 cases out of 4 (R0, R1 and R2 operations); re-resected patients are now alive at mean follow-up of 33.6 months (82, 12 and 7 months, respectively). In Group A patients, treated between January 1985 and December 1988 with partial mesorectal excision (RO) also for extraperitoneal localization, the incidence of local relapses is 21.9% (9/41 cases) vs 11.2% (11/98 cases) in Group B patients, treated from January 1989 with curative TME for extraperitoneal tumors. Conclusions. The incidence of local recurrences of extraperitoneal rectal cancer can be reduced by total mesorectal excision, The total sparing of pelvic autonomic nervous system in advanced rectal carcinoma doesn't increase the incidence of local recurrences.

Local recurrences and primary surgery in rectal carcinoma / DI MATTEO, Giorgio; Maturo, Alessandro; Redler, Adriano; D'Andrea, Vito; DI MATTEO, Filippo Maria; Montori, J; Peparini, Nadia; Zeri, K. P.; Mascagni, Domenico. - In: PANMINERVA MEDICA. - ISSN 0031-0808. - STAMPA. - 42 (3):(2000), pp. 201-205.

Local recurrences and primary surgery in rectal carcinoma

DI MATTEO, Giorgio;MATURO, Alessandro;REDLER, Adriano;D'ANDREA, Vito;DI MATTEO, Filippo Maria;PEPARINI, Nadia;MASCAGNI, Domenico
2000

Abstract

Background. The authors analyze retrospectively a consecutive series of rectal carcinomas operated on with different surgical strategies at Third Surgical Department of "La Sapienza" University of Rome, between January 1985 and December 1997, by one expert surgeon (GDM), and report the incidence of the local recurrence correlated to the surgical technique development. Methods. In most recent groups of patients treated for extraperitoneal neoplasm from January 1992 with curative (RO) total mesorectal excision (TME) and nerve sparing technique (NST) (Group C, n=47) and with curative TME plus lateral pelvic lymphadenectonmy (LPL) and NST (Group D, n=7), sacrificing the pelvic autonomic nervous system only in case of neoplastic infiltration, the local recurrence was 8.5% (4 cases, with mean interval of 30.5 months) and 0 respectively at mean follow-up of 44.9 and 55 months. Results, In none of the local recurrences of the Group C a re-resection (neither curative nor palliative) was possible and the survival was 50% at 14 months from the diagnosis of relapse, Instead, in local recurrences of rectal carcinoma in patients who underwent a first anterior resection with less extended dissection in other Department (Group E), a re-resection was possible for 3 cases out of 4 (R0, R1 and R2 operations); re-resected patients are now alive at mean follow-up of 33.6 months (82, 12 and 7 months, respectively). In Group A patients, treated between January 1985 and December 1988 with partial mesorectal excision (RO) also for extraperitoneal localization, the incidence of local relapses is 21.9% (9/41 cases) vs 11.2% (11/98 cases) in Group B patients, treated from January 1989 with curative TME for extraperitoneal tumors. Conclusions. The incidence of local recurrences of extraperitoneal rectal cancer can be reduced by total mesorectal excision, The total sparing of pelvic autonomic nervous system in advanced rectal carcinoma doesn't increase the incidence of local recurrences.
2000
01 Pubblicazione su rivista::01a Articolo in rivista
Local recurrences and primary surgery in rectal carcinoma / DI MATTEO, Giorgio; Maturo, Alessandro; Redler, Adriano; D'Andrea, Vito; DI MATTEO, Filippo Maria; Montori, J; Peparini, Nadia; Zeri, K. P.; Mascagni, Domenico. - In: PANMINERVA MEDICA. - ISSN 0031-0808. - STAMPA. - 42 (3):(2000), pp. 201-205.
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/250975
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 3
social impact