VOLUME 37 - NUMBER 6 - 2016

Open sphincter-preserving surgery of extraperitoneal rectal cancer without primary stoma and Fast Track Protocol

  • Pappalardo G., Coiro S., De Lucia F., Giannella A., Ruffolo F., Frattaroli F.M.
  • Original Article, 257-261
  • Full text PDF

  • Aim. Fast track protocol (FTP) showed to improve perioperative care. The study aims to evaluate the impact of the FTP in the open extraperitoneal rectal cancer (ERC) surgical treatment without a primary derivative stoma (DS) and the QoL in patients with or without a secondary DS. Patients and Methods. 50 patients affected by ERC were enrolled and operated on with open low anterior resection without a primary DS. They were randomized in two groups: one was treated perioperativelly in the traditional way (group T), the other using a modif ed FTP (group FT). A QoL questionnaire was administered prior to discharge and at 1-month follow-up. Results. Five courses (10%) were complicated by anastomotic leakage: 3 (12%) in the FT group (2 minor and 1 maior) and 2 (8%) in the T group (1 minor and 1 maior) (p=n.s.). All the maiors and one minor were treated with a DS. Patients of the group FTP were considered dischargeable earlier that those of group T (p<0.05). Patients with DS had a significantly lower QoL score (p<0.0001). Conclusion. FTP with minor modifications is feasible and safe in the ERC open surgery without using a DS. Better results were obtained without increasing complication rate. A secondary DS impacts detrimentally on QoL.

  • KEY WORDS: Rectal cancer - Fast Track Protocol - ERAS - Open surgery - Quality of life.