Abstract
The objectives: Were to determine the hospital frequency of abdominoperineal resection (APR); to determine mortality and morbidity rates and to assess oncologic outcomes. Method and patients: We performed a retrospective study between 2008 and 2013 in general surgery department at Gabriel Toure University Hospital (UH) which included all patients admitted for rectal cancer confirmed by pathological examination, and having undergone an APR. Results: We have collected 17 cases which accounted for 65.38% of curative resections of rectal cancer. The sex-ratio was 0.89 and the averageage was 49.53 years. The average tumor distance from the anal verge was 4.59 ± 1.7 cm. All patients had adenocarcinoma of the rectum. The histopathologic grade was well in 7 cases, moderate and poor in 5 cases each. According to the pathologic TNM classification, 13 patients were classified T4, 14 patients N+. APR was associated with hysterectomy and partial colpectomy in 4 cases. The average duration of interventions was 202.06 ± 25.68 minutes. The average duration of hospitalization was 18.24 ± 04.89 days. The postoperative mortality and morbidity rates were 5.88% and 29.42%, respectively. Local recurrence was observed in 6 patients and liver metastasis in 2 patients. The overall survival rate was 37.5% at 2 years and 18.75% at 5 years. Conclusion: APR still occupies an important place in our practice. Our results could be improved by the recent introduction of neoadjuvant radio chemotherapy in Mali.
Highlights
Abdominoperineal resection (APR) of the rectum consists, by a double abdominal and perineal approach, to remove the rectum, the sphincteric apparatus, the anal canal and the mesorectumin one piece; it ends with a definitive colostomy [1].It is indicated for cancers of the rectum for which a curative resection does not preserve the sphincter apparatus and for some anal cancers [1] [2] [3].Colorectal cancer is the fourth most common cancer in the world [4]
We performed a retrospective study between 2008 and 2013 in general surgery department at Gabriel Toure University Hospital (UH) which included all patients admitted for rectal cancer confirmed by pathological examination, and having undergone an abdominoperineal resection (APR)
We collected 17 APR cases in 6 years. These cases accounted for 23% of rectal cancer treatments (17/74), 29.82% of surgical treatments of rectal cancer (17/57) and 65.38% of curative surgical procedures (17/26) (Table 1)
Summary
Abdominoperineal resection (APR) of the rectum consists, by a double abdominal and perineal approach, to remove the rectum, the sphincteric apparatus, the anal canal and the mesorectumin one piece; it ends with a definitive colostomy [1].It is indicated for cancers of the rectum for which a curative resection does not preserve the sphincter apparatus and for some anal cancers [1] [2] [3].Colorectal cancer is the fourth most common cancer in the world [4]. Abdominoperineal resection (APR) of the rectum consists, by a double abdominal and perineal approach, to remove the rectum, the sphincteric apparatus, the anal canal and the mesorectumin one piece; it ends with a definitive colostomy [1]. It is indicated for cancers of the rectum for which a curative resection does not preserve the sphincter apparatus and for some anal cancers [1] [2] [3]. In Mali, in 2012, Coulibaly reported 81 cases of rectal cancer in 26 years in the Surgery B department of the Point G university hospital [7]. The objectives of this study were to determine the hospital frequency of the APR, to determine mortality and morbidity rates and to assess oncologic outcomes
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