Browsing by Author "Rajendra, S."

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    Ileal lipoma causing ileo - caecal intussusception in an adult
    (College of Surgeons of Sri Lanka, 2004) Rajendra, S.; Deen, K.I.
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    Result of trans-anal inter-sphincteric resection(taisr) combined with total mesorectal excision (ime) and colo- anal anastomosis for distal rectal cancer
    (The College of Surgeons of Sri Lanka and SAARC Surgical Care Society, 2003) Deen, K.I.; Rajendra, S.; Hewavisenthi, J.; Perera, M.T.P.R.; Satheesan, B.
    INTRODUCTION: The treatment of distal rectal cancer is controversial. Most prefer abdomino-perineal excision because of the potential for wide local clearance. Staplers have limitations in restorative resection for distal rectal cancer. OBJECTIVE: To audit the results ofcombinning TAISR with TME and handsewn colo-anal anastomosis for distal rectal cancer. METHODS: I 08 Patients (45 male, median age 59 years, range -22-87) with rectal cancer underwent abdomino-perineal resection -15 ( 14%), Hartmann's procedure - 7 (6.5%), anterior resection -39 (36%) and anterior resection or total colectomy with TAISR and colo-anal anastomosis -47 (43.5%). TAISR was undertaken for tumours between O and 7 ems from the anal verge for rectal cancer with familial polyposis. Data sought were; overall survival, local clearance (RO- clear margins; R l-at least one involved margin) and local recurrence at 24 month median follow up (range- 5 -89 months). Data in the TAISR group were compared with the rest by the test for proportions. Significance was assigned to p<0.05. RESULTS: For the entire group, operative 30-day mortality was 4.6%. Overall disease related mortality at 24 months was 18%. For the entire group, curative resection (RO) was achieved in 93(86%) { TAISR- 39 of 47 (83%) vs. resection without TAJSR- 54 of61(88.5%)- P>0.05}. Overall, local recurrence was seen in 8 (7.4%) {TAISR - 4 of 47 (8.5%) vs. resection without TAISR- 4 of 61 (6.5%). CONCLUSION: There was no significant difference in achievement of free resection margins and local recurrence, in the-short-term, employin anal inter-sphincteric resection with TME for distal rectal cancer co with resection for proximal rectai cancer. Trans-anal inter-sphincteric r with TME for distal rectal cancer is safe in trained hands and should preferred choice in surgical management of distal rectal cancer.