Anal sphincter preservation in locally advanced low @entity420 after preoperative chemoradiation therapy and coloanal XXXX .

@entity1 @entity834 @entity548 @entity5 @entity254 @entity850 @entity420
BACKGROUND AND OBJECTIVES: Standard treatment of @entity420 located 3-6 cm above anal verge is abdominoperineal resection. The objective was to evaluate feasibility, morbidity, and functional results of anal sphincter preservation after preoperative chemoradiation therapy and coloanal @entity254 in @entity1 with @entity420 located between 3 and 6 cm above the anal verge. METHODS: This study included 17 males and 15 females with a mean age of 54.8 +/- 15.4 years. @entity5 were located at a mean of 4.7 +/- 1.1 cm above the anal verge. The mean @entity5 size was 4.6 +/- 1.5 cm. All @entity1 received the scheduled treatment. Twenty-two @entity1 underwent coloanal @entity254 with the J pouch; 10 underwent straight @entity254 . Average surgical time was 328.7 +/- 43.8 min, and the average intraoperative @entity548 was 471.5 +/- 363.6 ml. The mean distal surgical margin was 1.3 +/- 0.6 cm. Five @entity1 (15.6%) received a blood transfusion. RESULTS: Major complications included @entity834 (three); pelvic abscess (three), and @entity850 (two). @entity5 stages were as follows: T0-2,N0,M0 = 12; T3,N0,M0 = 9; T1-3,N+,M0 = 9, and T1-3,N0-3,M+ = 2. Diverting stomas were closed in 30 @entity1 . Median follow-up was 25 months. Recurrences occurred in four @entity1 and were local and distant (n = 1) and distant (n = 3). Anal sphincter function was perfect (n = 20), incontinent to gas (n = 3), occasional minor leak (n = 2), frequent major soiling (n = 3), and colostomy (n = 2). CONCLUSIONS: In @entity1 with locally advanced @entity5 located 3-6 cm from anal verge who are traditionally treated with abdominoperineal resection, preservation of anal sphincter after preoperative chemoradiation therapy plus complete rectal excision with coloanal @entity254 is feasible and is associated with acceptable morbidity and no mortality.
