Long term observation of 367 cases of radical excision with anus preservation by casing anastomosis in low-rectal cancers.

BACKGROUND/AIMS: To evaluate the clinical curative effect, feasibility and safety of a newly designed anus-preserving operation in low rectal cancer; a retrospective analysis was carried out in 367 cases of low rectal cancer that underwent anus-preserving operation with casing anastomosis.

METHODOLOGY: Postoperative histopathology and Dukes stage were analyzed; 293 (293/367, 79.8%) cases were followed-up, the median time of the follow-up was 5.9 years.

RESULTS

Postoperative complications were observed in 20 patients, 13 (4.4%) cases of stoma leak, and 7 (2.4%) cases of stoma stenosis. Normal gastrointestinal function (defecation) occurred in all patients 12-24 weeks of post operation, 1-3 times per day. Local recurrence was 6.1% (18/293). Hepatic and lung metastasis was 14.7% (43/293) and 2.4% (7/293), respectively. The five year survival rate was 68.6%.

CONCLUSIONS

The casing anastomosis procedure designed in this study was safety and efficacy for low rectal cancer. With the procedure, anal function could be preserved well, stoma leak was decreased, and the 5-year survival rate was the same as Miles operation.