This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Oncological outcome of ultra‐low coloanal anastomosis with and without intersphincteric resection for low rectal adenocarcinoma. BJS 2007; 94: 341-345.

Published: 29th January 2007

Authors: G. Portier, L. Ghouti, S. Kirzin, R. Guimbaud, M. Rives, F. Lazorthes et al.

Background

The value of ultra‐low coloanal anastomosis (CAA) for rectal cancer is dependent on the oncological and functional results. The aim of this comparative study was to evaluate the long‐term oncological outcome of CAA with or without intersphincteric resection (ISR) for low‐lying rectal tumours.

Method

The study population comprised consecutive patients with low rectal cancer who underwent CAA in a single institution between 1977 and 2004. Patients were divided into two groups according to whether or not a partial ISR had been performed. Cox multivariate models were used for survival analysis.

Results

Some 278 patients underwent CAA with curative intent; 173 had ISR and 105 had CAA without ISR. Mean follow‐up was 66·8 months. The 5‐year actuarial rate for local recurrence, regardless of tumour stage, was 10·6 per cent in the ISR group versus 6·7 per cent for CAA alone (P = 0·405), and the 5‐year actuarial overall survival rate was 86·1 and 80·0 per cent respectively (P = 0·318). Cox multivariable analysis revealed that resection of the anal canal was not a prognostic factor for local or metastatic recurrence.

Conclusion

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