Biomaterial Database

Coloanal anastomosis following low anterior resection. 1992

P B Paty, and W E Enker

Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York.

Low anterior resection with coloanal reconstruction is indicated for rectal cancer when APR is not necessary and conventional LAR is not possible. LAR/CAA, in properly selected patients, yields results equivalent to those achieved with APR, since it encompasses equally the primary routes for regional spread. Most patients with midrectal tumors are candidates for LAR/CAA if an intrapelvic anastomosis is technically impossible. Complete dissection of the rectum and its mesentery to the anal hiatus of the pelvic diaphragm is essential for optimal cancer treatment and appropriate selection of cases for sphincter preservation. Careful attention to five technical points are essential for a successful outcome with respect to survival and function: (1) complete mobilization of the left colon; (2) sharp dissection; (3) restoration of the anorectal right angle and complete sacralization of the transposed colonic segment; (4) meticulous pelvic hemostasis and drainage to avoid septic complications; (5) routine use of diverting colostomy until completion of healing. In the long run, the LAR/CAA offers patients good function with few side effects and is universally preferable to a permanent colostomy. By avoiding permanent colostomy, cancer treatment is improved without compromising survival.

UI	MeSH Term	Description	Entries
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012004	Rectal Neoplasms	Tumors or cancer of the RECTUM.	Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D003106	Colon	The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON.	Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D003131	Combined Modality Therapy	The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.	Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000714	Anastomosis, Surgical	Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.	Surgical Anastomosis,Anastomoses, Surgical,Surgical Anastomoses
D001003	Anal Canal	The terminal segment of the LARGE INTESTINE, beginning from the ampulla of the RECTUM and ending at the anus.	Anal Gland, Human,Anal Sphincter,Anus,Anal Gland,Anal Glands, Human,Detrusor External Sphincter,External Anal Sphincter,Internal Anal Sphincter,Anal Sphincter, External,Anal Sphincter, Internal,Anal Sphincters,Detrusor External Sphincters,External Anal Sphincters,Human Anal Gland,Human Anal Glands,Internal Anal Sphincters,Sphincter, Anal,Sphincter, Detrusor External,Sphincter, External Anal,Sphincter, Internal Anal,Sphincters, Anal
D013514	Surgical Procedures, Operative	Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.).	Surgical Procedures,Ghost Surgery,Operative Procedures,Operative Surgical Procedure,Operative Surgical Procedures,Procedure, Operative Surgical,Procedures, Operative Surgical,Surgery, Ghost,Surgical Procedure, Operative,Operative Procedure,Procedure, Operative,Procedure, Surgical,Procedures, Operative,Procedures, Surgical,Surgical Procedure