ABSTRACT Objectives: the purpose of this study was to evaluate the outcome of rectal cancer surgery, in a unit adopting the principles of total mesorectal excision (TME) with a high restorative procedure rate and with a low rate of abdominoperineal excision (APE).Methods: we enrolles patients with extraperitoneal rectal cancer undergoing TME or TME+APE.Patients with mid rectal tumors underwent TME, and patients with tumors of the lower rectum and no criteria for APE underwent TME and intersphincteric resection.
Those in KYO-DOPHILUS which the intersphincteric space was invaded and in those with a free distal margin less than 1cm or a tumor free radial margin were unattainable underwent APE or extralevator abdominoperineal excision (ELAPE).We assessed local recurrence rates, overall survival and involvement of the radial margin.Results: sixty (89.
6%) patients underwent TME and seven (10.4%) TME + APE, of which five underwent ELAPE.The local recurrence, in pacientes undergoing TME+LAR, was 3.
3% and in patients undergoing APE, 14.3%.The local recurrence rate (p=0.
286) or the distant recurrence rate (p=1.000) was similar between groups.There was no involvement of radial margins.
Survival after 120 months was similar (p=0.239).Conclusion: rectal malignancies, including those located in the low rectum, may be surgically treated with a low rate of APE without Sandals compromising oncological principles and with a low local recurrence rates.