Critical assessment of the surgical treatment of low rectal adenocarcinoma in a reference hospital in Recife

Abstract

Objectives To evaluate the rates of abdominoperineal resection in patients with low rectal adenocarcinoma at the Hospital Barão de Lucena – SES/PE. Methodology This is a study based on the analysis of medical records of patients with low rectal adenocarcinoma submitted to surgical treatment at the Hospital Barão de Lucena Coloproctology Service between 2013 and 2016. Results It was observed that 77.5% of patients underwent abdominoperineal resection and 22.5% underwent anal sparing surgery. Most of the patients were male (62.5%), were under 70 years old (72.5%), presented a BMI less than 30 kg/m 2 (87.5%), presented American Society of Anesthesiologists (ASA) score I and III (82.5%), Rullier classification from I to III (95%) and TNM different from T1–T3 (95%). In 92.5% of medical records, there was no record of fecal continence before surgery. The most frequent period between the end of the radiotherapy and the surgery was over 11 weeks (57.5%); the most common distance from the tumor to the anal margin was between 3.1 and 4.0 cm (35% of patients). Conclusion There was a high rate of non-sparing anal sphincter surgeries. The only predictive factor for abdominoperineal resection was the presence of tumors classified as Rullier type III and IV.

Colostomies: A Brief Review

“…Bellato et al [1] found major prevalence of ostomized women in their study. In work of Marques et al [21] men with low rectal adenocarcinoma were more prevalent than women.…”

“…However, in abdominoperineal resection, by laparotomy or videolaparoscopy, there is amputation of the rectum, leaving the patient without anus. This approach was the most prevalent for lower rectal cancer, being performed in 77.5% of patients at a Brazilian hospital and only 22.5% of the patients had their sphincter preserved [21]. It demonstrates different realities between these two countries.…”

“…The abdominoperineal resection is a surgical procedure performed in patients with cancer of the medium or low rectum, in which a definitive colostomy is necessary, as the rectum is amputated, leaving the patient without an anus [14,21].…”