Pancreaticoduodenectomy requiring PV-SMVR was associated with a higher risk for R1 resection. The standardization of histopathological analysis has a clinically relevant impact on PFS data.

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In this report we describe our experience with conservative rectal resection using a combined abdominoperineal approach that allows low colorectal anastomosis to be performed without damaging the sphincter muscles. This series includes 30 men and 30 women operated on for rectal cancer (45 cases) and various other malignant (10 cases) and benign (5 cases) conditions of the lower two thirds of the rectum. Colorectal anastomosis was performed by hand in 27 cases and with an EEA 31 stapler in 33 cases; transit was temporarily inactivated by transverse loop colostomy in 80% of cases. 4 postoperative deaths were recorded (4/60 = 6.6%). Spontaneously reversed perineal fistula which occurred in 10 patients was the main postoperative complication. Functional results were satisfactory in all but 3 patients who required colostomy. In female patients this procedure is very simple; in males the use of surgical staplers has greatly obviated the anatomically related difficulties. This procedure would appear to be a useful alternative for restoration of intestinal patency in cases where the abdominal approach alone is unfeasible.