Clinical Outcome of Abdomino- Anal Resection for Lower Rectal Cancer with Colonic J-Pouch Coloanal Anastomosis Versus Abdominoperineal Resection

Purpose. This retrospective study evaluated the clinical outcome of abdomino-anal resection (AAR) of lower rectal cancer with colonic J-pouch coloanal anastomosis. Methods. Data for a total of 23 patients treated for lower rectal cancer using abdomino-anal resection (AAR) were compared with those of 37 patients treated with abdominoperineal resection (APR). Results. There was no significant difference of the general data and tumor condition between the two groups. The median follow-up time was 24months in both groups. The recurrence/metastasis rate was 52% in the AAR group and 35% in the APR group. The local recurrence (perineum and pelvic wall) rate was 43% in the AAR group and 25% in the APR group. The one year and two year survival rate was 95.2%, 76.6% in the AAR group and 89.2%, 71% in the APR group, respectively. In patients with earlier stage (not later than stage Ⅱa) there was no significant difference in disease-free survival and overall survival between the two groups. Conclusions: The results of this study suggest the use of AAR in patients with earlier stage of very low rectal carcinoma.