A retrospective study of middle- lower rectal malignancy resolved by trans anal total mesorectal excision after neoadjuvant chemoirradiation

Abstract

Author(s): Madhi Hashim Otaiwi Alatraikhim, Asaad Mohammed Kadhim* and Rami Mazin Harbi

Rectal cancer still one of frequent GIT malignancy in many countries. Chemotherapy, surgery and radiotherapy are necessary for management. The study aimed to evaluated retrospectively, the course of surgery, chemotherapy, and radiotherapy management of middle- lower rectal tumour. A retrospective cohort study which included 25 patients of both genders and different age who visit the outpatient clinics from May 2017 to March 2021. All patients were undergoing full history and examination, include age, gender, and CCRT. Rectal tumour basic information also have been collected. All patients received CCRT as 50.4 (G) over 28 fractions (daily) for 5 weeks with Capecitabine (Xeloda®) tables, however, surgery performed 4 weeks-6 weeks after last CCRT cycle. This study enrolled 25 patients (12 males (48%) and 13 females (52%)) with a mean age of 46.72 years ± 12.25 years. Out of 25 cases, 17 (68%) of cases were adenocarcinoma. Advanced stage III was common recorded in (13, 52%). In relation to site, tumours located in middle in 68%, while other located in lower rectum in 32%. Margins resected distally in 7-patient (28%), and proximally in 19-patients (72%). The complications include leakage (24%), ileus (4%), obstruction (8%), and fever (64%). All patients received neoadjuvant CCRT (100%). TME beyond CCRT are the promising management modality for locally advances rectal cancer. Adenocarcinoma local advanced stage III, and middle rectal mass is the commonest features of rectal cancer.

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