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At least 1,171 records · Page 65Linked to original sources
PubMed2003

[Minimal invasive treatment of early esophageal cancer and its precancerous lesion: endoscopic mucosal resection using transparent cap-fitted endoscope].

OBJECTIVE: To explore the effect of endoscopic esophageal mucosal resection using transparent cap-fitted endoscope to treat early esophageal cancer and severe hyperplasia, precancerous lesion of esophageal cancer. METHODS: Endoscopic esophageal mucosal resection were performed with transparent-cap technique on 29 cases of early esophageal cancer and 42 cases of severe hyperplasia, and the residual lesions were treated by Argon plasma coagulation (APC). All patients were followed up by endoscopic examination one month, 4 months, and 12 months after the therapy. RESULTS: (1) Local esophageal mucosa with the size of 21.8 mm +/- 1.02 mm x 18.2 mm +/- 1.02 mm on average was resected from 71 cases, with 88 lesions, using transparent cap-fitted endoscope. 1:1,000 saline-epinephrine at an average dose of 18 ml was injected submucosally for each lesion. (2) After the mucosectomy 5 cases had bleeding which was controlled successfully by compression, local injection of saline-epinephrine, and APC. None case suffered from perforation. Stenosis was found in 4 cases after mucosal resection, in three of which the extent of resected mucosa exceeded 3/4 of the esophageal circumference. Water-balloon dilator was used once a month for 3 - 4 times since one month after mucosal resection. All cases were cured. (3) The lesions of 58 cases (81.2%) were completely resected, and the remaining cases had residual lesions that were treated by APC. Three cases of early cancer and 2 cases of severe atypical hyperplasia were discovered endoscopically 4 months after resection and were cured by APC. (4) All cases survived without any discomfort after a follow-up of 4.6 months on average. CONCLUSION: Safe, simple, minimally invasive and effective on early esophageal cancer and precancerous lesion, endoscopic esophageal mucosal resection (EEMR) is promising clinically.

Adult↗
PubMed1992

[Recurrent hepatocellular carcinoma after hepatic resection].

A total of 125 patients with hepatocellular carcinoma (HCC) treated by hepatic resection in our department from 1970 to 1989 were reviewed to determine recurrent factors, recurrent modes of HCC and to assess the treatment for recurrent HCC. Seventy-five of 125 patients had recurrent tumors after the first hepatic resection. The 1-, 2-, and 3-year cumulative recurrent rates after hepatic resection were 25%, 52% and 67% respectively. The size of the tumor, intrahepatic metastasis, portal vein involvement, clinical stage and DNA ploidy pattern were judged as useful predictive factors for recurrence of HCC after hepatic resection. In the patients with intrahepatic metastases, the bilateral lobes of the remnant liver were the most frequent recurrent sites. The treatment for recurrent HCC was divided into 3 groups such as re-resection, transcatheter arterial embolization (TAE) and palliative treatment. The survival curves of patients receiving re-resection and TAE were significant better than those of patients receiving palliative treatment. Patients treated by re-resection for recurrent HCC had the longest survival. The 1-, 3- and 5-year cumulative survival rates after re-resection were 84%, 60% and 48% respectively. It is concluded that the early detection of recurrent HCC is important and re-resection or TAE is effective treatment for recurrent HCC.

Adult↗
PubMed1992

[Role of resection of the celiac plexus in the analgesic treatment of pancreatic cancers].

The aim of this study was to evaluate the pain relief related to resection of the celiac plexus in pancreatic carcinoma. This technique was attempted in 26 consecutive patients and performed in 23 (feasibility: 88%), whose mean age was 64 years. Before surgery, patients were divided into two groups: patients not treated by narcotic analgesics (group 1, n = 10) and patients treated by narcotic analgesics (group II, n = 13). Surgery was indicated in 22 patients for pancreatic resection or by-pass, and in 1 patient for pain relief after an unsuccessful per-cutaneous celiac plexus block. Resection of the celiac plexus was always performed via a trans-peritoneal approach, after mobilization of the head of the pancreas and the duodenum. Only the right half of the celiac plexus was resected in 4 patients (17%) due to technical difficulties. Pathologic examination was performed in 16 patients (8 patients from each group) and neoplastic involvement was observed only in 3 patients of group II. There was no operative death. Two complications related to this method occurred (9%). One patient developed a chylous ascites and was treated conservatively. In a second patient, an occlusion of the celiac trunk was complicated by infarction of the spleen and of the left lobe of the liver; this patient was reoperated and his subsequent post-operative course was uneventful. In group I, eight patients (80%) did not require narcotic analgesics after resection of the celiac plexus. Two failures occurred, one immediately after surgery and one delayed. In group II, seven patients (53%) did not require narcotic analgesics; 6 of these 7 patients died. Six failures occurred, 4 early after surgery and 2 delayed. Three of the 4 early failures occurred in patients who underwent resection of the right half of the celiac plexus. The authors concluded that resection of the celiac plexus seems to be an effective pain treatment in pancreatic carcinoma. However, resection must be bilateral to provide analgesia. Specific morbidity of this technique may lead to the use of non-surgical methods if surgery is not indicated for pancreatic resection or by-pass.

Adenocarcinoma↗
PubMed2003

[Usefulness of endoscopic mucosal resection for curative treatment of early gastric cancer].

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) has been widely accepted as a curative treatment of early gastric cancer (EGC). The aim of this study was to determine the usefulness and limitations of EMR for treatment of EGC by analyzing our own experience. METHODS: We retrospectively evaluated 51 EGC lesions (45 mucosal and 6 submucosal cancers) from 49 patients who had undergone EMR between Oct. 1997 and Aug. 2002 at Inha Universtiy Hospital. RESULTS: Among 45 lesions of mucosal cancer, enbloc resection was performed in 13 lesions and piecemeal resection in 32 lesions. Complete resection rates of enbloc and piecemeal resection were 84.6% and 43.8%, respectively (p=0.012). Complete resection rate of the lesions smaller than 1 cm in size was 71.4%, 1 to 2 cm in size 52%, and greazter than 2 cm in size 37.5%. Complete resection rates of well, moderately, and poorly differentiated EGC were 59.4%, 71.4%, and 16.7%, respectively (p=0.048). Thirty-three patients underwent a follow-up endoscopy at I month after EMR and two were found to have residual cancers. One patient who had a piecemeal EMR showed cerical and abdominal lymph node metastasis 10 months after EMR. CONCLUSIONS: In selected patients with EGC, EMR can be a curative treatment modality. However, complete resection rate is low in large sized and poorly differentiated EGCs and when piecemeal resection is performed.

Aged↗
PubMed2004

Advanced lung cancer invading the left atrium wall treated with pneumonectomy and combined resection of the left atrium using stapling devices: report of two cases.

In chest surgery, stapling devices are primarily used to close bronchi. However, they are also used for dissection and suturing between lung lobes, resection and plication of lung tissue (including bullae), combined resection of the superior vena cava, closure of the pulmonary great vessels, closure of the left atrium following combined resection of the left atrium, and so on. We recently treated two cases of advanced lung cancer, which had invaded the left atrial wall, with pneumonectomy and combined resection of the left atrium using stapling devices, and obtained favorable results. For combined resection of the left atrium, it is safer to use stapling devices than vascular clamps, since the latter involve the risk of dislocation during use. Furthermore, since stapling devices require no margin for suturing, the left atrium can be resected at a point sufficiently distant from the cancer, thus allowing for highly radical resection. Stapling devices are also useful because they can be manipulated even within narrow operative fields. When dealing with lung cancer requiring combined resection of the left atrium, pneumonectomy is needed in most cases. When performing surgery for these cases, it is essential to first close and divide the bronchi and pulmonary arteries and veins as far as possible so that adequate adherence around the left atrium can be developed and the entire lung can be lifted up, followed by resection of the left atrium with a stapling device applied to the left atrium without any tension.

Aged↗
PubMedDate not supplied

[Radiofrequency-assisted hepatic resection--first experience].

AIMS: Intra-operative blood loss during liver, resection remains a major concern due to its association with higher postoperative complications and shorter long-term survival. The aim of this study was to assess the feasibility and safety of a novel concept for liver resection using a Radio-Frequency energy assisted technique. METHODS: From January 2001 to January 2002, 27 patients were operated on using Radio-Frequency energy assisted liver resection. Radio-Frequency energy was applied along the resection edge to create a 'zone of desiccation' prior to resection with a scalpel. RESULTS: Median resection time was 47.5 minutes (range 30-110). The median blood loss during resection was 30 mls (range 15-992) and mean pre-operative and post-operative haemaglobin values were 13.5 g/dL (SD+1.7) and 11.6 g/dL (SD+1.4) respectively. No blood transfusion was registered, nor was any mortality observed. There was one post-operative complication: a sub-phrenic abscess. Median post-operative stay was 8 days (range 5-86). CONCLUSION: Liver resection assisted by RF energy is feasible, easy and safe. This novel technique offers a new method for 'transfusion-free' resection without the need for sutures, ties, staples, tissue glue or admission to Intensive Care Unit.

Adult↗
PubMed2005

[The comparative results of radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma].

BACKGROUND/AIMS: Although surgical resection remains the gold standard of therapy for hepatocellular carcinoma (HCC), only selected patients can undergo resection because of the severity of the underlying cirrhosis or due to the diffuse distribution of the tumor. Radiofrequency ablation (RFA) has recently shown comparable results to surgical resection for the treatment of HCC. We compared the results of RF ablation and surgical resection for the treatment of HCC. METHODS: From January 2000 to December 2002, one hundred-sixty patients who had undergone surgical resection or RFA were analyzed retrospectively. The patients with a tumor size less than 5 cm in diameter, with less than 3 tumors in number, with tumor having a Child-Pugh class A classification and no evidence of extrahepatic metastasis were enrolled in the study. The recurrence pattern was classified into local and distant recurrence. We compared the recurrence patterns, the survival rates, the recurrence rates and the complications between the two groups. RESULTS: 1) The local recurrence rate was 9.8% for surgical resection and 18.2% for RFA and the distant recurrence rate were 32.8% and 28.3%, respectively. 2) The 1-, 2- and 3-year overall cumulative survival rates after RFA and surgery were 95.8%, 86.8%, 80.0%, 98.3%, 87.0% and 77.4%, respectively. 3) The incidence of complication was similar between the two groups. CONCLUSIONS: Radiofrequency ablation shows comparable results to surgical resection for the treatment of HCC. Therefore, RFA should be considered as the treatment of choice those patients who are not candidates for resection. However, intrahepatic recurrence of tumor after RFA was as frequent as that seen after surgical resection. Further investigation is warranted to clarify whether the current RFA technology could offer improved long-term results.

Adult↗
PubMedDate not supplied

Endoscopic piecemeal mucosal resection of large colorectal tumors.

BACKGROUND/AIMS: Since endoscopic en bloc resection of large and sessile tumors is technically difficult, endoscopic en bloc piecemeal mucosal resection (EPMR) is usually chosen for resection of such tumors. Tumors resected by EPMR are, however, difficult to evaluate histologically. The aim of this study was to evaluate the safety and effectiveness of EPMR. METHODOLOGY: We removed 30 large colorectal tumors in 30 patients by EPMR between 1992-2000. Endoscopic examination was repeated at 3, 6 and 12 months and later on after initial endoscopic resection. Patients in whom no residual tumor was found by both endoscopic and histologic examination were considered to be "cured". RESULTS: Histological examination of the resected tumor tissues revealed malignancy in 43.3% (13/30). Three patients had invasive malignant tumors and underwent surgery. Following complete endoscopic resection, recurrences were observed in 2 patients with benign tumors, which were resected by additional endoscopic resection. All patients including the two with non-invasive malignant tumors remain free from recurrence during a mean follow-up period of 45.2 months (range, 3-104 months). Bleeding was the only complication and was seen in one patient (3.3%; 1/30), which was treated by endoscopic clipping. CONCLUSIONS: EPMR of benign or non-invasive large malignant tumors is a safe and effective procedure. Complete excision of large, sessile and non-invasive tumors is possible, although complete removal by EPMR cannot be verified histologically.

Adenoma↗
PubMed2005

[Endoscopic mucosal resection in the treatment of early cancer of the gastrointestinal tract].

Endoscopic mucosal resection is a minimally invasive technique of resection of large pieces of the superficial layers (the mucosa and partially the submucosa) of the gut wall. In the present study we are presenting currently established indications, recent advances in the technique, early and long-term results of the treatment of esophageal, gastric and colorectal early cancer by endoscopic mucosal resection based on the review of the literature, educational materials and personal experience from the training of the first author (KZ) at the National Cancer Center in Tokyo, Japan. Endoscopic mucosal resection should be indicated for every superficial neoplastic lesion of the gut wall that can be safely removed in its entirety by experienced endoscopic team, and subsequently processed and evaluated properly by cooperating histopathologist specializing in gastrointestinal pathology. Eventually a detailed analysis of a resected specimen enables the precise assessment of curability of the procedure and establishment of the rational management of a patient. Curative endoscopic resection allows for regarding this procedure as sufficient and includes a patient into a follow-up program. Potentially curative endoscopic resection requires to consider the risk of lymph node involvement and discuss with a patient potential benefits and risk associated with surgical treatment or its withholding in reference to patients' age and health condition. Non-curative endoscopic resection requires to recommend an additional local (endoscopic resection, endoscopic ablation, brachytherapy) or surgical treatment after a detailed analysis with a patient a potential benefit and risk associated with each option. Despite enormous advance in medical knowledge the outcome of the gastrointestinal cancer treatment is still far unsatisfactory. Early diagnosis and treatment of less advanced cancer remains the most promising method of improvement of the outcome. We hope that popularization of the knowledge regarding early gastrointestinal cancer may improve their early detection rate and thereby the outcome of the treatment.

Colonic Neoplasms↗
PubMed2005

[Endoscopic mucosal resection for the treatment of superficial adenocarcinima developed on the Barrett's mucosa].

We present a new technique of endoscopic mucosal resection for the treatment of extended superficial lesions of the esophagus such as early squamous cell carcinoma, high grade intraepithelial neoplasia or early adenocarcinoma arising in Barrett's esophagus. A modified rigid esophagoscope has been designed. A large mucosal area is sucked against a perforated 180 degrees window. Mucosal resection is performed by an electrical wire loop at a constant depth of 1 +/- 0,1 mm. The resected surface varies from 4 to 12 cm2. Circumferential resection consists of two opposite hemi-circumferential resections. The resection yields one or two specimens only for histological study allowing easy orientation and analysis of the resection margins. The deep resection margin is precisely located at the submucosal level, a prerequisite for a safe resection of T1a cancers.

Adenocarcinoma↗
PubMed2005

History of limited resection for non-small cell lung cancer.

A retrospective study of limited resection for lung cancer in a large number of patients was first reported in the 1970s. The reported outcome of segmentectomy was comparable to that of standard lobectomy. The North American Lung Cancer Study Group (LCSG) performed a randomized controlled clinical trial to compare limited resection (segment or wedge) with lobectomy for T1N0 (stage IA) non-small cell lung cancer (NSCLC) in the 1980s. The study revealed a significant excess of intrathoracic recurrence rate and a tendency to poorer survival in the limited resection group. Since then, limited resection has not been considered the standard operation for lung cancer. However, this situation is gradually changing, because the recent introduction of chest computed tomography (CT) to mass surveys has made peripherally located lung cancer detectable at the earliest stage. Several recent non-randomized studies of intentional limited resection from Japan demonstrated good outcomes comparable to those of lobectomy. Organ-sparing wedge resection without systematic dissection of lymph nodes may be suitable for some types of small lung cancers detected only by CT. Our meta-analysis of published data comparing survival rates after limited resection and lobectomy for stage I lung cancer revealed that limited resection was comparable to lobectomy. Further studies are necessary to define precise targets of intentional limited resection for lung cancer.

Carcinoma, Small Cell↗
PubMedDate not supplied

Factors affecting the prognosis of anatomical liver resection for liver metastases from colorectal cancer.

BACKGROUND/AIMS: Liver resection has improved the survival of colorectal cancer patients with metastases. However, there are groups at high risk of recurrence after liver resection. This report reviews our results using anatomical liver resection and analyzes the prognostic factors. METHODOLOGY: We analyzed 78 patients who underwent anatomical liver resection of liver metastases from colorectal cancer between June 1988 and March 2002. RESULTS: Twenty-nine patients had synchronous metastases, and 49 had metachronous. The 5-year overall survival rate was 43%. Patients with more than three metastatic tumors had a significantly poorer 5-year recurrence-free survival rate. There was no statistical difference in the 5-year overall survival rate between patients with metachronous metastases (41%) and those with synchronous (44%) metastases. The 5-year overall survival rate was significantly poorer for patients with an interval of 1 year or less between colorectal and liver resections than for patients with a longer interval. Recurrence after liver resection occurred in 38 patients (49%). The recurrences occurred in the lung in 18 patients, in remnant liver in 15 patients, in lymph nodes in 7 patients, and in other organs in 6 patients. CONCLUSIONS: We conclude that anatomical liver resection of liver metastases from colorectal cancer improves survival. Liver metastases that occur within 1 year of colorectal resection may need an interval of observation before liver resection.

Adult↗
PubMedDate not supplied

Repeated resection for intra-abdominal and retroperitoneal liposarcomas: long-term experience in a single cancer center in Japan.

Intra-abdominal or retroperitoneal liposarcomas are huge, and local recurrence is a common event. There is still no consensus concerning debulking or repeated resection. Twelve patients who had surgery for intra-abdominal or retroperitoneal liposarcomas at the Cancer Institute Hospital (Tokyo, Japan) during 1981-2002 were enrolled. Eight patients underwent complete resection, for a resectability rate of 67%. Combined resection of adjacent organs was necessary to obtain clear margins in 10 of the 12 patients (83%). A patient who underwent R2 resection survived 13.2 years in a dormant state without tumor regrowth. Resection of second (five patients), third (three patients), or seventh (one patient) for local recurrence or regrowth tumors was successfully performed. A patient survived 21.5 years after four R0 resections and three R2 resections. Our experience suggests that both near-total and repeated resection might improve survival benefit.

Abdominal Neoplasms↗
PubMed1979

[Experimental and clinical studies on blood coagulation and lysis system after hepatic resection (author's transl)].

Blood coagulation and lysis system was studied with other biochemical serum analysis in three groups of mongrel dogs; laparotomy without hepatic resection (group I), with 50% hepatic section (group II), and 70% hepatic resection (group III). In clinical studies, six cases of hepatic tumors and one case of hepatoma with cirrhosis were selected for examinations. All the data examined in group I were restored toward normal within 48 hours. Total serum protein level was significantly decreased after hepatic resection. The protein level in group III was lower than in group II on the 4th postoperative day (P less than 0.01). In clinical studies, low serum protein levels did not reach a preoperative value even 3 weeks after extended right hepatic lobectomy. Time course of Al-P and transaminase changes in clinical studies was similar to that in experimental study with dogs. Al-P and transaminase showed an abnormally high level in the patient with hepatic cirrhosis. Serum bilirubin levels were not increased after hepatic resection. In blood coagulation and lysis system, serum fibrinogen levels were markedly decreased: 50% reduction in group III and 30% reduction in group II on the first postoperative day. The degree of decrease in the fibrinogen level was proportional to the size of resected volume of the liver. On the other hand, in clinical studies fibrinogen levels were slightly decreased. In the case of hepatic resection with cirrhosis, however, the values were markedly decreased: 40% reduction on the 4th and 25% on the 21st postoperative days. Fibrinolysis system was accelerated group II and III. The acceleration continued until 3 weeks after hepatic resection. From these results it may be concluded that analysis of blood coagulation and lysis system after hepatic resection is useful in evaluating a residual hepatic function after partial resection and in selecting a treatment suitable for hepatic insufficiency.

Adolescent↗
PubMed1989

Stereotactic biopsy and resection of thalamic astrocytomas.

In this study of 72 patients who had histologically verified thalamic astrocytomas, 44 patients underwent stereotactic serial biopsy, 22 underwent stereotactic resection of the neoplasm, and an additional 6 patients underwent stereotactic biopsy followed by stereotactic resection of the tumor at a later date. Of the 50 patients who underwent stereotactic biopsy, 3 were neurologically worse after the procedure (morbidity, 6%), and 3 additional patients with Grade 4 astrocytomas who preoperatively were rapidly deteriorating neurologically, died within 30 days of the procedure. Of the 28 patients who underwent stereotactic resection, 14 were neurologically improved after the procedure, 10 were unchanged, and 4 were worse. One additional patient died 10 days postoperatively. Thirty-four patients had Grade 4 astrocytomas: 27 underwent stereotactic biopsies. The mean survival after biopsy and irradiation for patients with Grade 4 astrocytomas was 21.4 weeks. The mean survival was 62 weeks in 7 patients with Grade 4 astrocytomas who underwent stereotactic resection and radiation therapy. The mean survival time after biopsy and radiation therapy for patients who had Grade 3 and Grade 2 lesions was 54.4 weeks and 91 weeks, respectively. Twenty-three patients had pilocytic astrocytomas; 8 underwent stereotactic biopsies, and 19 underwent stereotactic resection of the tumor (4 of these underwent biopsy prior to resection). There was no neurological morbidity, but one patient died after resection. Many of those who underwent resection were deteriorating due to an enlarging tumor mass or recurring cyst, and had undergone more conservative therapies such as biopsy and radiation. Even though stereotactic biopsy is appropriate in many patients harboring thalamic astrocytomas, selected patients with significant mass effect from solid tumor or recurring cyst can benefit from stereotactic resection.

Adolescent↗
PubMedDate not supplied

[Regeneration ability of ischemic liver and the effect of liver resection and extracts stimulating proliferation].

DNA synthesis was studied in liver nuclei of Wistar rats after 30% liver tissue resection, 2 hr ischemia of 70% liver tissue or 2 hr ischemia of 70% liver tissue with resection of intact lobes. DNA synthesis was markedly increased in ischemic lobes and was especially high in ischemic lobes if simultaneous resection of intact lobes occurred; maximum of the synthesis was observed within 32 hrs after the operation. Proliferation stimulating extracts, isolated from liver tissue within 48 hrs after the resection or after ischemia, intensified the regenerating processes in the resected liver tissue; the first preparation (from resected liver tissue) exhibited the most distinct effect as compared with the second extract (from ischemic liver tissue). Proliferation stimulating extracts did not affect the cytochrome P-450, content of which was decreased after resection and ischemia. The data obtained suggest the important role of proliferation stimulating factors in regeneration of liver tissue after ischemia or resection; these factors proved to be possible to isolate from ischemized and reperfused liver tissue; the medicinal effect of resection was shown.

Animals↗
PubMed1988

A prospective study of perioperative and postoperative control of acid hypersecretion in patients with Zollinger-Ellison syndrome undergoing gastrinoma resection.

Fifty-five consecutive patients with Zollinger-Ellison syndrome who underwent exploratory laparotomies for gastrinoma resection were evaluated prospectively to determine the effect of gastrinoma resection on acid secretion and to establish criteria for safe and effective perioperative management of gastric acid hypersecretion. In 15 patients (27%) no tumor was found and postoperative serum gastrin, basal acid output (BAO), and maximal acid output (MAO) were unchanged. Twenty-one patients (38%) had gastrinomas resected and were biochemically cured. Median fasting gastrin, median delta secretin, mean BAO, and mean MAO decreased 89%, 94%, 80%, and 43%, respectively, at 3-month follow-up in these patients. In 19 patients gastrinomas were resected, but patients were not cured, and median fasting gastrin, median delta secretin, mean BAO, and mean MAO decreased 47%, 10%, 26%, and 25%, respectively. Forty percent of patients with gastrinoma resected and cured and 81% of patients with gastrinoma resected but not cured continued to hypersecrete acid (BAO greater than 10 mEq/hr) at 3- to 6-month follow-up. Acid control was managed perioperatively during gastrinoma resection by continuous intravenous infusion of H2 receptor antagonists at a dose established by preoperative titration to decrease acid output to less than 10 mEq/hr. Thirty patients were treated with cimetidine at a mean dose of 3.2 mg/kg/hr for a mean of 13.8 days. Twenty-one patients were treated with ranitidine at a mean dose of 1.1 mg/kg/hr for a mean of 8 days. No patients suffered any complications related to acid hypersecretion or side effects of the H2 antagonists. Patients undergoing gastrinoma resection can be managed safely by continuous infusion of H2 antagonists. Successful gastrinoma resection can reduce acid output, but even 40% of biochemically cured patients will continue to hypersecrete acid at short-term follow-up and will require continuation of antisecretory medication.

Adult↗
PubMed1986

Abdominosacral resection of the rectum.

Abdominosacral resection is the most reliable radical sphincter saving operation for midrectal cancers which are too low for anterior resection. The posterior incision provides maximum exposure for wide resection of the tumor, a measured distal margin, and an accurate anastomosis. The procedure can be carried out consistently to the pelvic floor without disrupting the anal sphincters and their innervation. Sphincter function is consistently preserved. The risk of abdominosacral resection is comparable to that incurred for anterior resection or abdominoperineal resection. Mortality rate is 2%. Morbidity can be limited by the selective use of a protective colostomy. The use of abdominosacral resection has extended sphincter saving resection to include 77% of 646 consecutive patients with rectal cancer. Abdominosacral resection provides the maximum clearance around the tumor and long term follow up has revealed no greater risk of local recurrence or death from cancer.

Abdominal Muscles↗