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Surgical Technique More Effective for Low Rectal Cancer

Cylindrical technique removes more tissue around tumor than standard approach

MONDAY, June 16 (HealthDay News) -- Abdominoperineal excision of low rectal cancer removes more tissue around the tumor if a cylindrical technique performed in the prone position is used rather than the standard approach, according to a report published online June 9 in the Journal of Clinical Oncology.

Nicholas P. West, from the University of Leeds in the United Kingdom, and colleagues retrospectively examined outcomes in 128 patients who underwent abdominoperineal excision of their rectal cancer, where the excision was performed by a standard technique for 101 patients and by a cylindrical approach in 27 patients.

The researchers found that the cylindrical technique was significantly better in removing more tissue in the distal rectum. There was significantly greater distance from the muscularis propria or internal sphincter to the anterior, posterior and lateral resection margins, which was associated with significantly lower circumferential resection margin involvement and intraoperative perforations, they report. One surgeon who switched from the standard technique to the cylindrical approach had a significant increase in the amount of tissue removed from the distal rectum, which significantly reduced circumferential resection margin positivity and perforations, the authors note.

"Cylindrical abdominoperineal excision performed in the prone position for low rectal cancer removes more tissue around the tumor that leads to a reduction in circumferential resection margin involvement and intraoperative perforations, which should reduce local disease recurrence," West and colleagues conclude.

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