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Research article
Kimihiko Funahashi
Toho University Omori Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5158-9378
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Rectal amputation (RA) remains an important surgical procedure for salvage despite advances in sphincter-preserving resection, including intersphincteric resection. The aim of this study was to compare short- and long-term outcomes of RA with an initial perineal approach to those of RA with an initial abdominal approach (conventional abdominoperineal resection (APR)) for primary anorectal cancer. Methods: We retrospectively analyzed the short- and long-term outcomes of 48 patients who underwent RA with an initial perineal approach (perineal group) and 21 patients who underwent RA with an initial abdominal approach (conventional group). Results: For the perineal group, the operation time was shorter than that for the conventional group (313 vs. 388 minutes, p = 0.027). The postoperative complication rate was similar between the two groups (43.8 vs. 47.6%, p = 0.766). Perineal wound complications (PWCs) were significantly fewer in the perineal group than in the conventional group (22.9 vs. 57.1%, p = 0.006). All 69 patients underwent complete TME, but positive CRM was significantly higher in the conventional group than in the perineal group (0 vs. 19.0%, p = 0.011). There were no significant differences in the recurrence (43.8 vs. 47.6%, p = 0.689), 5-year disease-free survival (63.7% vs. 56.7%, p = 0.665) and 5-year overall survival rates (82.5% vs. 66.2%, p = 0.323) between the two groups. Conclusion: These data suggest that RA with an initial perineal approach for selective primary anorectal carcinoma is advantageous in minimizing PWCs and positive CRMs. Further investigations on the advantages of this approach are necessary.
Keywords
rectal amputation with an initial perineal approach; sphincter-preserving resection; low-lying rectal cancer near the anus
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CURRENT STATUS: Published
View the published article at BMC Surgery.
Version 2
Posted 11 Dec, 2019
No community comments so far
Editorial decision: Minor revision
On 13 Jan, 2020
Review #2 received
Received 06 Jan, 2020
Review #1 received
Received 16 Dec, 2019
Reviewer #2 agreed
On 14 Dec, 2019
Reviewers invited
Invitations sent on 11 Dec, 2019
Reviewer #1 agreed
On 11 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Editorial decision: Major revision
On 20 Nov, 2019
Review #2 received
Received 17 Nov, 2019
Reviewer #2 agreed
On 01 Nov, 2019
Review #1 received
Received 28 Sep, 2019
Reviewers invited
Invitations sent on 05 Sep, 2019
Reviewer #1 agreed
On 05 Sep, 2019
Submission checks complete
On 29 Jul, 2019
Editor assigned
On 23 Jul, 2019
Editor invited
On 22 Jul, 2019
First submitted
On 21 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Surgery
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A new preprint design is coming!
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See the published version of this preprint at BMC Surgery.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Kimihiko Funahashi
Toho University Omori Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5158-9378
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Surgery.
Version 2
Posted 11 Dec, 2019
No community comments so far
Editorial decision: Minor revision
On 13 Jan, 2020
Review #2 received
Received 06 Jan, 2020
Review #1 received
Received 16 Dec, 2019
Reviewer #2 agreed
On 14 Dec, 2019
Reviewers invited
Invitations sent on 11 Dec, 2019
Reviewer #1 agreed
On 11 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Editorial decision: Major revision
On 20 Nov, 2019
Review #2 received
Received 17 Nov, 2019
Reviewer #2 agreed
On 01 Nov, 2019
Review #1 received
Received 28 Sep, 2019
Reviewers invited
Invitations sent on 05 Sep, 2019
Reviewer #1 agreed
On 05 Sep, 2019
Submission checks complete
On 29 Jul, 2019
Editor assigned
On 23 Jul, 2019
Editor invited
On 22 Jul, 2019
First submitted
On 21 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Surgery.
Background: Rectal amputation (RA) remains an important surgical procedure for salvage despite advances in sphincter-preserving resection, including intersphincteric resection. The aim of this study was to compare short- and long-term outcomes of RA with an initial perineal approach to those of RA with an initial abdominal approach (conventional abdominoperineal resection (APR)) for primary anorectal cancer. Methods: We retrospectively analyzed the short- and long-term outcomes of 48 patients who underwent RA with an initial perineal approach (perineal group) and 21 patients who underwent RA with an initial abdominal approach (conventional group). Results: For the perineal group, the operation time was shorter than that for the conventional group (313 vs. 388 minutes, p = 0.027). The postoperative complication rate was similar between the two groups (43.8 vs. 47.6%, p = 0.766). Perineal wound complications (PWCs) were significantly fewer in the perineal group than in the conventional group (22.9 vs. 57.1%, p = 0.006). All 69 patients underwent complete TME, but positive CRM was significantly higher in the conventional group than in the perineal group (0 vs. 19.0%, p = 0.011). There were no significant differences in the recurrence (43.8 vs. 47.6%, p = 0.689), 5-year disease-free survival (63.7% vs. 56.7%, p = 0.665) and 5-year overall survival rates (82.5% vs. 66.2%, p = 0.323) between the two groups. Conclusion: These data suggest that RA with an initial perineal approach for selective primary anorectal carcinoma is advantageous in minimizing PWCs and positive CRMs. Further investigations on the advantages of this approach are necessary.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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