engleski

SURGERY FOR RECTAL CANCER IN UNIVERSITY HOSPITAL "DUBRAVA"

Introduction: The results of surgical treatment for rectal cancer have been improved in the last decades. In this retrospective study we analyzed surgical treatment for rectal cancer in the Department of surgery in our hospital in period from January 2000 till December 2005. Patients and methods: A database of 220 patients who underwent surgery for rectal cancer (up to 16 cm from anal verge), at Clinical Hospital Dubrava between the period from January 2000 till December 2005 was reviewed. From their medical charts we collected information regarding age, sex, distance of cancer from anal verge, type of operation, Dukes classification, postoperative morbidity and mortality. The type of surgery and complication were compared with recent literature. Results: From 220 patients 58% were male and 42% were female with medium age of 64.9 years ( range 48-88). Histopathological classification according to Dukes revealed : Dukes A in 44( 20.7 %) , Dukes B in 50 (23.6%), Dukes C in 67 (31.6%) and Dukes D in 41 (19.3%) cases. There were four types of procedures : abdominoperineal excision in 80 (36.6%) patients, anterior resection in 110 ( 50%) , paliative Hartmann procedure with permanent colostomy in 25 (11.4%) , and local transanal excision in 5(2.3%) pts. The most common post operative complication was wound infection 10% mainly perineal wounds after abdominoperineal excision. Anastomotic leakage occured in 9.5% cases. The postoperative mortality was 2.3%. Conclusion: Our data shows that abdominoperianal excision , a classical standard surgical technique for rectal cancer, has been gradually replaced by sphincter-saving surgery, althought the number of patients operated with this procedure is still high.There is no doubt that subset of patients with rectal cancer will still require abdominoperineal excision. The rate of postoperative complications is acceptable and comparable with other reports.

rectal cancer

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