Estudo comparativo entre a amputação de reto na posição clássica de Lloyd-Davies e em decúbito ventral.

OBJECTIVE: to evaluate the benefits and disadvantages of the ventral decubitus position compared with that of Lloyd-Davies in patients submitted to abdominoperineal amputation of the rectum. METHODS: we conducted a retrospective study of 56 patients submitted to abdominoperineal amputation of the rectum due to distal rectal and anal canal neoplasms, treated at the Central Hospital of the Santa Casa de Misericordia in Sao Paulo between 2008 and 2017. RESULTS: patients' mean age was 63.08 years, 48.2% of them women and 51.8%, men. Adenocarcinoma was the histological type, in 94.6% of cases, and squamous cell carcinoma, in 5.4%. The position of Lloyd-Davies was adopted in 66.1% of the procedures, and the ventral position, in 33.9%. At the time of surgery, four patients had synchronous metastases: hepatic (one case), pulmonary (one case) and simultaneous liver and lung (two cases). Neoadjuvant treatment was performed in 85.7% of the patients. Late postoperative complications occurred in 13 patients operated in the classic position and in one patient operated on in the ventral decubitus position. The overall survival time for the group operated in the classic position was on average 45.7 months, while in the group operated on in the ventral decubitus position it was 15.5 months. CONCLUSAO: o grupo da posicao ventral apresentou menor necessidade de infusao de volume intravenoso intraoperatorio e menos complicacoes pos-cirurgicas tardias, enquanto que o grupo Lloyd-Davies obteve melhores tempos cirurgicos e anestesicos. Recidiva, tempo livre de doenca e sobrevida global devem ser avaliados em um tempo maior de seguimento.