摘要
Background -The aim of the study was to assess both mortality and morbidity following resection ofmid and low rectal cancers in a French prospective multicentric study. Patients -From June to September 2002, consecutive patients undergoing resection for cancer of the mid-or lower rectum were prospectively included in amulticentric study. Both postoperative mortality and morbidity were recorded. Multivariate statistical analysis was performed in order to assess risk factors predictive of postoperative morbidity. Results -238 patients with a mean age of 66±13 years (range: 26-88) were included. Neoadjuvant radiotherapy was performed in 68%of the patients. Totalmesorectal excision was performed in 218 patients (92%), of whom 151 (63%) had a sphincter saving procedure. Six patients died (2.5%). Overall postoperative morbidity rate was 43%, including anastomotic leakage (11%) and reoperation (5%). Mean hospital-in-stay was 20 ±16 days (range: 3-191). Four independent risk factors of morbidity were found: perioperative fecal contamination (OR = 3.9 [1.1; 13.5]), mean operating time longer than 6 hours (OR = 4.5 [1.7; 12.1]), ASA score > 2 (OR = 3.2 [1.6; 7.9]), and smocking (OR = 3.3 [1.2; 8.9]). Conclusions -Resection of cancer involving the middle or lower rectum with sphincter saving procedures was possible in two-thirds of the patients and was associated with 2.5%mortality and 43%morbidity.
Background -The aim of the study was to assess both mortality and morbidity following resection ofmid and low rectal cancers in a French prospective multicentric study. Patients -From June to September 2002, consecutive patients undergoing resection for cancer of the mid-or lower rectum were prospectively included in amulticentric study. Both postoperative mortality and morbidity were recorded. Multivariate statistical analysis was performed in order to assess risk factors predictive of postoperative morbidity. Results -238 patients with a mean age of 66±13 years (range: 26-88) were included. Neoadjuvant radiotherapy was performed in 68%of the patients. Totalmesorectal excision was performed in 218 patients (92%), of whom 151 (63%) had a sphincter saving procedure. Six patients died (2.5%). Overall postoperative morbidity rate was 43%, including anastomotic leakage (11%) and reoperation (5%). Mean hospital-in-stay was 20 ±16 days (range: 3-191). Four independent risk factors of morbidity were found: perioperative fecal contamination (OR = 3.9 [1.1; 13.5]), mean operating time longer than 6 hours (OR = 4.5 [1.7; 12.1]), ASA score > 2 (OR = 3.2 [1.6; 7.9]), and smocking (OR = 3.3 [1.2; 8.9]). Conclusions -Resection of cancer involving the middle or lower rectum with sphincter saving procedures was possible in two-thirds of the patients and was associated with 2.5%mortality and 43%morbidity.
