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A Leggeri

Publications and source records attributed to A Leggeri.

At least 37 records · Page 2Linked to original sources
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[Low anterior resection in the curative surgical treatment of rectal cancer].

Abdominoperineal resections for rectal cancer are being performed with decreasing frequency in favour of sphincter-saving resections. It remains to be demonstrated that sphincter preservation has not resulted in compromised local disease control, disease-free survival and survival. For this purpose 315 patients with rectal carcinoma have been studied. In 44 cases (13.9%) it was only possible to perform a colostomy; a curative resection has been carried out in 206 (65.3%). Sphincter-saving procedure was performed whenever possible: the length of margin of resection was at least 2 cm. The operation were: 61 abdominoperineal excisions (AP), 135 anterior resections (AR), 10 transanal excisions (excluded from this analysis). The distribution of tumors in the various Duke's stages was: Dukes A--28 patients, Dukes B--143, Dukes C--35. The thirty-days mortality was 6 patients (9.8%) for AP and 6 (4.4%) for AR. Local recurrence was: AP 9 cases (16.1%), AR 16 cases (12.4%); for tumors 4-8 cm from anal verge recurrence was 18.7% for AP, 17.1% for AR. Concerning staging, local recurrence was more common in the Dukes C stage (36%) than in the Dukes B (11.2%) or in the Dukes A (3.7%). 5 years survival after AP was 54.6 percent and after AR 57.9 percent. Concluding, in our experience, there was no significant relationship between local recurrence or survival and type of curative surgery (AP or AR). Local recurrence and survival were only related to tumor stage (p less than 0.01): lateral tumor extension in these advanced and aggressive lesions appears to be the major determinant of local recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Role of abdominoperineal resection in the surgical treatment of cancer of the rectum].

The respective indications for abdomino-perineal amputation and colorectal resection are being debated, especially in the treatment of mid-rectal cancer. We report a series of 242 patients operated on for cancer of the rectum, including 200 who underwent tumor resection, which aimed to be curative in 162 cases. In the choice of intervention we took into account the possibility of keeping a distal margin of security of at least 2 cm when carrying out the resection. The size of the tumor, its staging and degree of differentiation did not influence our choice. Operative mortality was 9.8% for amputations and 5.3% for resection; deaths occurring in patients over 65 years and in only two cases for specific reasons. Local recurrence developed in 16.3% of amputations and in 12.5% of resections. For the mid-rectum these percentages were respectively 20 and 10.7%, though this difference may partially be explained by a greater number of patients with Dukes stage C, among the patients undergoing amputation. Five year survival was 56.8% for amputation and 63.2% for resection. We therefore feel that abdomino-perineal amputation does not produce a better tumor clearance than resection, and that it should currently only be proposed in cases where a resection with a satisfactory margin of security cannot be ensured.

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