[Importance of rectal extirpation for the therapy concept of XXXX ].

@entity1 @entity5 @entity189 @entity260 @entity14 @entity694 @entity3816
INTRODUCTION: The main objective of surgery of @entity189 is to avoid a permanent colostomy by sphincter-sparing surgical procedures. A variety of different abdominoperineal resection rates is described in the literature. MATERIAL/METHOD: The study was performed in 2000 within the framework of a multicentric study including 282 hospitals. The purpose of the study was to document the quality of diagnosis and therapy for @entity14 .A total of 9477 @entity1 were included in this study: 3402 suffering from a @entity189 and 6075 suffering from a @entity694 . RESULTS: A total of 866 abdominoperineal resections was performed. This corresponds to an abdominoperineal resection rate of 27.4%. In 30.4% of all @entity1 and in 23.0% of all @entity1 an abdominoperineal resection was performed. Of all @entity5 @entity1 who underwent abdominoperineal resection, 8.3% had a pT4 @entity189 and 57.5% a pT3 @entity189 . Adapted to the localization of the @entity5 in the rectum, i.e., the distance of the @entity5 margin to the anal verge, the following abdominoperineal resection rates were found: <4 cm from the anal verge 84.6%, 4-7.9 cm 43.9%, 8-11.9 cm 5.8%, and 12-16 cm 0.5%. @entity3816 occurred in 11.8%, specific @entity260 in 33.1%, and general @entity260 in 27.4% of the @entity1 . The postoperative lethality was 2.8%. The mean postoperative hospital stay was 21.7 days. Logistic regression identified the body mass index, gender, the distance of the @entity189 from the anal verge, and the T category as independent factors influencing the abdominoperineal resection rate. DISCUSSION: Despite an overall decrease in use, abdominoperineal resection will continue to play an important role for the surgical treatment of @entity5 in routine clinical practice in Germany. It will remain an individual decision for each @entity1 whether the @entity5 and the @entity1 allow sphincter preservation or whether abdominoperineal resection seems to be necessary. According to the results of the present study,a general definition of an abdominoperineal resection rate in an unselected group of @entity1 should be viewed critically.
