Laparoscopic Abdominal Transanal Proctocolectomy with Coloanal Anastomosis Is a Good Surgical Option in Selective Patients with Low-Lying Rectal Cancer: A Retrospective Analysis Based on a Single Surgeon's Experience

摘要

Purpose: We intended to identify the oncological outcome for rectal cancer over the past 20 years and whether or not sphincter-preserving surgery is an appropriate approach for low-lying rectal cancer. Materials and Methods: The oncological outcomes from a total of 418 patients who electively underwent rectal cancer surgery for a lesion located within 8 cm of the anal verge by a single colorectal surgeon were reviewed retrospectively. Results: Of 418 patients, 175 patients underwent low anterior resection (LAR), 172 laparoscopic abdominal transanal proctocolectomy with coloanal anastomosis (LATA), and 71 abdominoperineal resection (APR). The factors related to the disease-free survival (DFS) were neoadjuvant chemoradiation ( P = .016), pathologic stage ( P P P = .016) and postoperative serum carcinoembryonic antigen level ( P P P P = .001), than was LAR or LATA. Discussion: The LATA procedure is a technically feasible and oncologically safe surgical option for low-lying rectal cancer. We suggest that LATA may be a good surgical option in selective low-lying rectal cancer patients.