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Master Thesis

L’anastomose colo-anale différée sans stomie de protection après exérèse totale du mésorectum pour cancer est-elle sûre et efficace ? Étude rétrospective sur 85 patients

Abstract : Objectives: retrospective monocentric study of feasibility, complications and oncologic outcomes of DCAA for middle and low rectal cancer. Patients and methods: patients underwent a 2-step surgery: first step was low anterior resection with TME mostly laparoscopic and trans anal pull-through; second step consisted in a straight DCAA without stoma on day 6. Mortality, morbidity and oncologic outcomes were reported. Results: 85 patients were included (69 men) from May 2000 to September 2013 (median age 63). Median follow-up was 60 months. Thirty-day mortality was 2.5%. Global morbidity was 41%, with 11% of anastomotic leakage and 25% of pelvic sepsis. About one on four patients had a definitive stoma. Concerning oncologic results, 74% of patients had pre-operative chemo radiotherapy. Resection was classified R1 in 6 patients. Global recurrence rate was 38% with 18% of local recurrence (median time to recurrence 16 months). Five-year overall survival was 70%, and 5-year disease free survival was 59%. Conclusion: DCAA for rectal cancer is feasible, with high complications rate despite theoretical advantages. One in two patient will take advantage of the procedure without stoma or recurrence.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01233708
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Submitted on : Thursday, November 26, 2015 - 1:32:33 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
Long-term archiving on: : Saturday, April 29, 2017 - 1:59:46 AM

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  • HAL Id : dumas-01233708, version 1

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Pierre-Yves Sage. L’anastomose colo-anale différée sans stomie de protection après exérèse totale du mésorectum pour cancer est-elle sûre et efficace ? Étude rétrospective sur 85 patients. Médecine humaine et pathologie. 2015. ⟨dumas-01233708⟩

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