Local recurrence following total mesorectal excision with double-stapling anastomosis for XXXX : analysis of risk factors.

@entity1 @entity5 @entity3
This study reviewed the local recurrence rate in @entity1 who had undergone total mesorectal excision and double-stapling low anterior resection for mid and @entity5 . It also aimed to identify risk factors for local recurrence through univariate and multivariate analyses. Consecutive @entity1 with @entity5 within 12 cm of the anal verge treated with total mesorectal excision and double-stapling low anterior resection from August 1993 to December 2000 were studied. The demographic data, operative details, @entity5 characteristics, and follow-up data were collected prospectively. Factors that might affect the local recurrence rate were analyzed with univariate and multivariate analyses. A total of 270 @entity1 were included in the study (156 @entity1 , 114 @entity1 ). The mean +/- SD age was 64.83 +/- 11.27 years. The mean +/- SD level of the @entity5 was 7.17 +/- 1.90 cm. All anastomoses were performed within 5 cm of the anal verge. During the mean follow-up of 35.5 months, 12 @entity1 developed local recurrence. The 5-year actuarial local recurrence rate was 7.3%. The presence of @entity3 and the resection margin of < or = 1 cm were found to be risk factors for local recurrence in the univariate analysis. In the multivariate analysis, the presence of @entity3 was the only independent factor for local recurrence. In the group of @entity1 with @entity3 , proximal @entity5 (6-12 cm from the anal verge) were shown to have a significantly lower local recurrence than those within 6.1 cm from the anal verge (4.2% vs. 37.8%; p <0.001). Low anterior resection performed with double stapling and total mesorectal excision achieved a local recurrence rate of 7.3%. The presence of @entity3 was the only independent risk factor for local recurrence. A high local recurrence rate was associated with @entity5 (? 6 cm from the anal verge) with @entity3 . Adjuvant therapy for local control should be considered for this subgroup of @entity1 .
