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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/19584
Title: Outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain, and risk factors for anastomotic leakage
Authors: Varut Lohsiriwat
Darin Lohsiriwat
Wiroon Boonnuch
Vitoon Chinswangwatanakul
Thawatchai Akaraviputh
Woramin Riansuwan
Narong Lert-Akyamanee
Mahidol University
Keywords: Medicine
Issue Date: 1-Aug-2008
Citation: Digestive Surgery. Vol.25, No.3 (2008), 191-197
Abstract: Background/Aims: To evaluate the outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain and to determine factors influencing anastomotic leakage. Methods: We investigated 170 patients undergoing elective sphincter-saving operation without protective stoma and pelvic drain during 2003-2006 in a single institution. Early postoperative outcomes were evaluated. 17 independent patient-, tumor-, and treatment-related variables were analyzed by a multivariate model to determine their association with anastomotic leakage. Results: The patients' median age was 64 years. Median tumor height was 8 cm (range 3-15) from the anal verge. Overall 30-day mortality rate was 1.2%. Postoperative complications were diagnosed in 38 patients (22%) including 14 cases of anastomotic leakage (8.2%), of which 10 cases (71%) required surgical intervention. Tumor height within 5 cm from the anal verge was the only independent factor for leakage (OR 4.04; 95% CI 1.25-13.08). Conclusion: A sphincter-saving operation without a protective stoma and pelvic drain can be performed safely in the vast majority of rectal cancer patients. Tumor height within 5 cm from the anal verge is an independent risk factor for anastomotic leakage. Thus, the routine use of a protective stoma and pelvic drainage might be unnecessary. Copyright © 2008 S. Karger AG.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=49449113858&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/19584
ISSN: 02534886
Appears in Collections:Scopus 2006-2010

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