Acceptance of a 5-mm distal bowel resection margin for XXXX : is it safe?

@entity1 @entity5
AIM: Acceptance of a short distal bowel margin results in a higher rate of anterior resection but may compromise oncological safety. This study aimed to evaluate the safety of a 5-mm distal margin. METHOD: A retrospective analysis was carried out of 412 consecutive @entity1 with @entity5 treated with anterior resection with a negative circumferential resection margin. Radiotherapy was given to 63% of @entity1 with an advanced @entity5 . The median follow up was 75 months. RESULTS: Fewer @entity1 in the group with a distal margin of  <= 5 mm had a @entity5 with an advanced pT stage compared to @entity1 in the group with a distal margin of > 5 mm (P = 0.033). Two @entity1 were converted to abdominoperineal resection because of a positive 'doughnut', leaving 410 @entity1 , in whom 5.4% (95% CI, 0-11.3%) of the group with a distal margin of  <= 5 mm had local recurrence at 5 years compared with 4.2% (95% CI, 2.1-6.3%) of the group with a distal margin of > 5 mm (P = 0.726). The corresponding figures for the 5-year overall survival were 82.4% (95% CI, 72.6-92.2%) vs 76.3% (95% CI, 71.8-80.8%) (P = 0.581). All four anastomotic recurrences occurred in the group with a distal margin of > 5 mm. CONCLUSION: A distal margin of  <= 5 mm did not compromise oncological safety in @entity1 undergoing preoperative radiation for an advanced @entity5 .
