Journal article
Impact of Pelvic Radiotherapy on Morbidity and Durability of Sphincter Preservation After Coloanal Anastomosis for Rectal Cancers
Diseases of the colon & rectum, Vol.51(1), pp.32-37
2008
DOI: 10.1007/s10350-007-9099-x
PMID: 18030527
Abstract
Purpose: This study was designed to assess the impact of pelvic radiotherapy on the incidence of complications and colostomy-free survival of patients after a coloanal anastomosis for rectal cancer.
Methods: A total of 192 patients underwent a coloanal anastomosis between 1982 and 2001: 87 patients did not receive pelvic radiotherapy; 105 patients received pelvic radiotherapy (39 preoperative and 66 postoperative). Early and late complications requiring surgical intervention and the colostomy-free survival rate were assessed by retrospective review of patient records.
Results: After a median follow-up of 62 months, 151 patients were alive. The most frequent complication was development of an anastomotic stricture (5-year rate of a stricture, 16 percent; 95 percent confidence interval, 10-21). Patients receiving pelvic radiotherapy had a higher rate of complications other than anastomotic strictures, including fecal incontinence, fistulas, abscesses, and bowel obstructions compared with patients not receiving pelvic radiotherapy (5-year rate: 20 percent (95 percent confidence interval, 10-29) vs. 5 percent (95 percent confidence interval, 0-10); P = 0.001). Patients receiving pelvic radiotherapy had a lower colostomy-free survival than did patients not receiving pelvic radiotherapy (5-year colostomy-free rate: 72 percent (95 percent confidence interval, 62-84) vs. 92 percent (95 percent confidence interval, 86-98); P < 0.001). There was no significant difference in the colostomy-free survival of patients receiving preoperative and postoperative pelvic radiotherapy.
Conclusions: After coloanal anastomosis, a significant number of patients will have complications requiring surgical intervention, and some will require a permanent colostomy. Pelvic radiotherapy, whether it is administered preoperatively or postoperatively, significantly increases the need for a permanent colostomy.
Details
- Title: Subtitle
- Impact of Pelvic Radiotherapy on Morbidity and Durability of Sphincter Preservation After Coloanal Anastomosis for Rectal Cancers
- Creators
- Imran HASSAN - Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, United StatesDavid W LARSON - Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, United StatesBruce G WOLFF - Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, United StatesRobert R CIMA - Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, United StatesHeidi K CHUA - Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, United StatesDieter HAHNLOSER - Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, United StatesMegan M O'BYRNE - Section of Biostatistics, Mayo Clinic, Rochester, Minnesota, United StatesDirk R LARSON - Section of Biostatistics, Mayo Clinic, Rochester, Minnesota, United StatesJohn H PEMBERTON - Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, United States
- Resource Type
- Journal article
- Publication Details
- Diseases of the colon & rectum, Vol.51(1), pp.32-37
- Publisher
- Springer; Secaucus, NJ
- DOI
- 10.1007/s10350-007-9099-x
- PMID
- 18030527
- ISSN
- 0012-3706
- eISSN
- 1530-0358
- Language
- English
- Date published
- 2008
- Academic Unit
- Surgery
- Record Identifier
- 9984051796702771
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