Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | luni, 22 aprilie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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LOCAL RECURRENCE AFTER TOTAL MESORECTAL EXCISION - A CURRENT ISSUES
Lili-Gabriela Lozneanu, G. Dimofte, Simona Nicolescu, V. Boboc, E. Tarcoveanu
„I. Tănăsescu – Vl. Buţureanu” First Surgical Clinic
„Gr.T. Popa” University of Medicine and Pharmacy Iaşi
Jurnalul de chirurgie 2011; 7 (3): 359-367
Full text:
Format PDF (Română/Romanian)

Abstract:

Background: Despite the major improvements that have been made in both surgical technique and adjuvant radio(chemo)-therapy, local recurrence still remains a challenge and is difficult to treat. The introduction of total mesorectal excision (TME) has increased the patient’s outcome. Methods: By investigating a prospective rectal cancer trial (23 consecutive patients, from one single surgeon which has undergone training in TME) over a period of 7 years the factors responsible for the poor outcome were determined and the causes leading to local recurrence were assessed. Results: 23 patients had undergone potential curative anterior resections with TME and stoma diversion, followed by mechanical anastomoses using stapling devices. All patients were diagnosed with rectal adenocarcinoma, with a median level of 8 cm from the anal verge. There were 3 local recurrences (13.04%), in one case being associated with distant recurrence. The median follow-up period was 30 months. The analysis of recurrent cases revealed a lot of imputable errors in the learning period. Conclusions: Lowering pelvic recurrences is possible by the continue improvement of dissection technique by training. There is a learning curve, and the results are very different after the achievement of optimal dissection technique.

KEY WORDS: RECTAL CANCER, TOTAL MESORECTAL EXCISION, LOCAL RECURRENCE, LEARNING CURVE

Correspondence to: Lili-Gabriela Lozneanu, MD, „I. Tănăsescu – Vl. Buţureanu” First Surgical Clinic, St Spiridon University Hospital, str. Independenţei, nr. 1, 700111, e-mail:



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Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.