SURGICAL-TREATMENT OF LOWER RECTAL-CANCER WITH SPHINCTER PRESERVATIONUSING HANDSEWN COLOANAL ANASTOMOSIS

The present study was designed to evaluate the technical feasibility a nd oncologic results of Del.forming handsewn coloanal anastomosis (CAA ). A total of 46 patients treated for lower rectal cancer using CAA we re retrospectively studied, and the oncologic results were compared wi th those of 105 patients treated with abdominoperineal resection (APR) , CAA was performed in patients who had both good mobility of the tumo r and a distal clearance margin of more than 1.0 cm, No significant di fference was noted in the mortality: rates following the two operation s (CAA 2.2% vs APR 1.9%), Pelvic recurrence was detected in two patien ts (4.5%) after CAA and in six patients (7.2%) after APR. The 5-year s urvival rate after CAA was 79.2% and that after APR was 72.6%. No sign ificant difference was noted in the incidence of pelvic recurrence or the survival rates between the two operations. These results show that CAA could be an excellent reconstructive option in the treatment of l ower rectal carcinoma for selected patients.