TY - JOUR
T1 - Oncologic and functional results after abdominoperineal resection plus pseudocontinent perineal colostomy for epidermoid carcinoma of the anus
AU - Goéré, Diane
AU - Bonnet, Stéphane
AU - Pocard, Marc
AU - Deutsch, Eric
AU - Lasser, Philippe
AU - Elias, Dominique
PY - 2009/5/1
Y1 - 2009/5/1
N2 - PURPOSE: Surgical treatment for epidermoid carcinoma of the anus is reserved for patients after failure of primary chemoradiotherapy and consists of abdominoperineal resection with permanent iliac colostomy. The purpose of this study was to analyze the oncologic and the functional outcomes after abdominoperineal resection and pseudocontinent perineal colostomy for epidermoid carcinoma of the anus after external radiation at maximal doses (60 Gy). METHODS: Between 1990 and 2006, 95 patients underwent abdominoperineal resection for an epidermoid carcinoma of the anus. Eighteen (19 percent) underwent construction of a pseudocontinent perineal colostomy. Functional results were evaluated prospectively at regular intervals. RESULTS: Complete resection (R0) was obtained in 17 of 18 patients. After a median follow-up of 33 (range, 12Y198) months, 15 of 18 patients were alive, and 11 were disease free. Five-year overall and disease-free survival rates were 67 and 53 percent, respectively. Functional outcomes were available for 16 patients. According to the Kirwan score, 15 were continent, and 13 did not require pad protection. Overall, 15 of 16 patients were satisfied. CONCLUSION: Pelvic reconstruction with a pseudocontinent perineal colostomy does not compromise the beneficial effect of salvage surgery, seems to be safe and feasible even after a high dose of radiotherapy, and provides a high degree of satisfaction.
AB - PURPOSE: Surgical treatment for epidermoid carcinoma of the anus is reserved for patients after failure of primary chemoradiotherapy and consists of abdominoperineal resection with permanent iliac colostomy. The purpose of this study was to analyze the oncologic and the functional outcomes after abdominoperineal resection and pseudocontinent perineal colostomy for epidermoid carcinoma of the anus after external radiation at maximal doses (60 Gy). METHODS: Between 1990 and 2006, 95 patients underwent abdominoperineal resection for an epidermoid carcinoma of the anus. Eighteen (19 percent) underwent construction of a pseudocontinent perineal colostomy. Functional results were evaluated prospectively at regular intervals. RESULTS: Complete resection (R0) was obtained in 17 of 18 patients. After a median follow-up of 33 (range, 12Y198) months, 15 of 18 patients were alive, and 11 were disease free. Five-year overall and disease-free survival rates were 67 and 53 percent, respectively. Functional outcomes were available for 16 patients. According to the Kirwan score, 15 were continent, and 13 did not require pad protection. Overall, 15 of 16 patients were satisfied. CONCLUSION: Pelvic reconstruction with a pseudocontinent perineal colostomy does not compromise the beneficial effect of salvage surgery, seems to be safe and feasible even after a high dose of radiotherapy, and provides a high degree of satisfaction.
KW - Anus
KW - Epidermoid carcinoma
KW - Salvage surgery
UR - http://www.scopus.com/inward/record.url?scp=67651166805&partnerID=8YFLogxK
U2 - 10.1007/DCR.0b013e31819f2a4b
DO - 10.1007/DCR.0b013e31819f2a4b
M3 - Article
C2 - 19502862
AN - SCOPUS:67651166805
SN - 0012-3706
VL - 52
SP - 958
EP - 963
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
IS - 5
ER -