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Master Thesis

Indications et résultats de la tumorectomie transanale chirurgicale pour tumeur rectale

Abstract : Management of low and middle rectal tumors remains a controversy in regard to surgical and oncological management. Trans-anal tumor resection is proposed as alternative to rectal resection with lower morbidity and mortality. However, the indications and oncological results are still debated. M: We present a retrospective, monocentric study, comparative between the surgical tumor resections from CHU Bordeaux performed between 2001 and 2017 for tumors of low middle rectum. We spread the cohort in three groups: non-infiltrative polyps, cancer operated immediately, and cancer operated after radio-chimio-therapy. The objective is to evaluate the evolution in time of the indications of tumor resection, to evaluate the morbidity and mortality and to compare the oncological results in the different cancer groups. R: Between January 2001 and December 2017, 320 patients were treated by local resection for rectal tumor (cancer or polyp). Eighty-two patients had polypectomy, 111 and 127 for cancer without and with neo-adjuvant treatment. There is an increase over time for local resections for cancer and the interventions after pre-operative treatment while the number of surgical lumpectomies decrease. The morbidity is not influenced by radiotherapy or the surgical technique. The only significant risk factor is the ASA score 3-4. For the 2 cancer groups, the global survival rate and without relapse is 84% and 70% respectively with a median follow-up of 35 months. C: The tumor resection occupies a place more and more important in the management od rectal tumors. The morbidity is low and oncological results are satisfactory for the patients well selected.
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Submitted on : Tuesday, March 3, 2020 - 12:00:30 PM
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Hélène Jacquemet. Indications et résultats de la tumorectomie transanale chirurgicale pour tumeur rectale. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02496790⟩



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