ABSTRACT

OBJECTIVE:

To evaluate the results of abdominosacral resections for locally recurrent rectal cancers which were fixed to sacrum.

METHODS:

Total six patients (five male, one female) ages between 25 and 63 were treated by abdominosacral resections. All patients had previous low anterior resections. Single stage surgical procedures were performed. Sacrectomy levels were sacral 2 for three patients and sacral 3 for the remaining three patients. Coloanal anastomosis (2 patients), abdominoperineal resection (three patients) and pelvic exantration (one patient) were the preferred procedures.

RESULTS:

Postoperative hospital stay was between 25 and 35 day. Although there was no mortality, morbidity was 100%. Only two patients had tumor free surgical margins and those patients had long survival (mean more than 40 months). Four patients who had positive surgical margins had mean 15 months survival. One year survival was 66% and three years survival was 40%.

CONCLUSION:

Abdominosacral resections results with significant morbidity and long hospital stays. Despite these, abdominosacral resections can provide long term survival. We recommend abdominosacral resections for posterior fixed locally recurrent rectal cancers, if tumor free margins can be achieved.