RESULTS OF SURGERY IN CARCINOMA RECTUM WITH SPHINCTER PRESERVATION.

Introduction: Cancer o fcolon and rectum is the most common cancer of the gastrointestinal tract.Various factors are attributed to interplay between environmental,dietary factors and lifestyle of the patients with carcinoma rectum. Objective: This article covers the profile of these patients,comparison for complications rates between hand sewen anastomosis and circular stapled anastomosis ,recurrence rates,disease free and overall survival, different adjuvant regimes in patients undergoing sphincter preservation surgery. Materials and methods: 70 Patients (carcinoma rectum proven )with growth between 6-12cm from analverge were taken from July 2007 to June 2010 and were followed upto december2010. Result: This study revealed that carcinoma rectum has slightly more male prepondrance with bleeding per rectum as the most common symptom.46patients underwent circular stapled anastomosis and 24 patients underwent handsewen anastomosis.Most common complication postoperatively was anastomotic leak and rectal stenosis being the most common delayed complication in circular stapled anastomosis.Post operative chemotherapy and radiotherapy was given in all patients with stage II and stage III disease.Most common local recurrence was seen in rectum and liver being the most common site for distant metastasis. Discussion: Anastomotic leak remains the most common complication after sphincter preservation.Local recurrence is most common in local rectal region itself and liver remains the most common site for distant metastasis.Circular stapled device has rendered safe low anastomosis.TME remains the standard treatment to achieve best oncological outcome in middle and lower rectal cancers.Adjuvant treatment has definite role in stage II and stage III disease. With widespread acceptance of distal 2cm tumor free margin,sphincter preservation using circular stapler anastomosis has rendered safe low rectal anastomosis.