Is pull-through an acceptable replacement for low anterior resection for rectal cancers in low-income setting? A case-control study.
APR, Abdominal perineal resection
CRT, Chemoradiotherapy
FU, Fluorouracil
LAR, Low anterior resection
Low anterior resection
Low-income
PT, Pull-through
Pull-through
Rectal cancer
SPSS, Statistical Package for the Social Sciences
STROCSS, Strengthening the reporting of cohort studies in surgery
Stapler
TME, Total mesorectal excision
Trans-anal
Journal
Annals of medicine and surgery (2012)
ISSN: 2049-0801
Titre abrégé: Ann Med Surg (Lond)
Pays: England
ID NLM: 101616869
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
25
05
2021
revised:
19
07
2021
accepted:
25
07
2021
entrez:
17
8
2021
pubmed:
18
8
2021
medline:
18
8
2021
Statut:
epublish
Résumé
Colorectal cancers are the second most common cancers overall and are the third deadliest cancers. Complete resection is the treatment of choice for rectal cancers and chemoradiotherapy (CRT) is strongly recommended in stage 2 and 3. Low anterior resection (LAR) is the most common procedure used, but it requires the use of stapler which might be very expensive as one study estimated the median cost of LAR inpatients to be over 13.000 USD. However, coloanal pull-through (PT) used to be the common procedure before introducing staplers in the twentieth century and can be less expensive, but with higher complication rates. This is a retrospective case-control study from patients' records who underwent either LAR or PT for their rectal cancer in Syria. All patients had either stage 2 or 3 cancer and were treated by the same group of surgeons and received the same adjuvant and neoadjuvant CRT protocol. Patients from both groups had the same prognosis and stages. This study included 60 participants, of which, 30 had LAR and 30 had PT. They all had successful removal of the cancer and follow-ups were for 1 year after the surgery. There were no significant differences between the two procedures in post-operative leak, urinary retention, stricture, sexual function and recurrence (p > 0.05). However, post-operative incontinence was more frequent with PT (p = 0.027). PT can be an acceptable substitute of LAR in low income settings despite having higher incidence of incontinence.
Sections du résumé
BACKGROUND
BACKGROUND
Colorectal cancers are the second most common cancers overall and are the third deadliest cancers. Complete resection is the treatment of choice for rectal cancers and chemoradiotherapy (CRT) is strongly recommended in stage 2 and 3. Low anterior resection (LAR) is the most common procedure used, but it requires the use of stapler which might be very expensive as one study estimated the median cost of LAR inpatients to be over 13.000 USD. However, coloanal pull-through (PT) used to be the common procedure before introducing staplers in the twentieth century and can be less expensive, but with higher complication rates.
MATERIALS AND METHODS
METHODS
This is a retrospective case-control study from patients' records who underwent either LAR or PT for their rectal cancer in Syria. All patients had either stage 2 or 3 cancer and were treated by the same group of surgeons and received the same adjuvant and neoadjuvant CRT protocol. Patients from both groups had the same prognosis and stages.
RESULTS
RESULTS
This study included 60 participants, of which, 30 had LAR and 30 had PT. They all had successful removal of the cancer and follow-ups were for 1 year after the surgery. There were no significant differences between the two procedures in post-operative leak, urinary retention, stricture, sexual function and recurrence (p > 0.05). However, post-operative incontinence was more frequent with PT (p = 0.027).
CONCLUSION
CONCLUSIONS
PT can be an acceptable substitute of LAR in low income settings despite having higher incidence of incontinence.
Identifiants
pubmed: 34401125
doi: 10.1016/j.amsu.2021.102608
pii: S2049-0801(21)00558-6
pmc: PMC8358644
doi:
Types de publication
Journal Article
Langues
eng
Pagination
102608Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
We have no conflict of interest to declare.
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