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ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 4  |  Page : 89-97

Abdominosacral resection versus abdominoperineal resection in patients with low rectal carcinoma in terms of exposure/operating time/bleeding


1 Department of General Surgery and Colorectal Surgery Clinic, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
2 Department of Pediatric Surgery, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
3 Department of General Surgery, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
4 Department of Surgical Oncology, Netaji Subhas Chandra Bose Cancer Hospital, Kolkata, West Bengal, India
5 Department of General Surgery, Arambagh Super Specialty Hospital, West Bengal, India

Correspondence Address:
Dr. Sujitesh Saha
DL 50, Sector II, Salt Lake, Kolkata - 700 091, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/WJCS.WJCS_2_19

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Background: Comprising nearly 30% of all colorectal cancers, rectal cancer continues to be a significant medical and social problem. Abdominiperineal resection (APR) remains the procedure of choice for patients with rectal carcinoma. An alternative to APR is abdominosacral resection (ASR). Objective: We aim to assess the various modes of presentation, demographic profiles, and histopathological characteristics of tumors, and evaluate the efficacy of ASR over APR in terms of exposure, operating time, bleeding, etc., especially in the perineal/sacral part of the procedure. Design: This was a prospective observational study.Setting: This study was conducted at a superspeciality government hospital in eastern India. Patients and Methods: Patients diagnosed with low rectal carcinoma were included in the study. Two groups were formed using a stratified model of sampling theory; one group underwent APR while the other ASR. Main Outcome Measures: For patients with low rectal cancer, ASR is a feasible approach with reduced bleeding, lesser operating time in the perineal/sacral part of dissection, better exposure, and good oncological outcome.Sample Size: Thirty participants were included in the study. Results: Of the total study participants, 63% were males and 36% females. Patients in their 30s and 40s were the most commonly affected age group. Per-rectal bleeding was the most common presentation. The most common histological tumor encountered was well-differentiated adenocarcinoma. The mean operating time and mean blood loss with regards to the perineal/sacral part of the dissection was less in ASR than that in APR. In addition, the exposure was better in ASR. Ninety-three percent of the patients undergoing ASR had total mesorectal excision. Conclusion: ASR is a feasible approach for low rectal carcinoma and performs better in certain aspects than APR. Limitations: This study had a short duration and included less number of patients. Conflict of Interest: None.


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