대한대장항문학회

We compared the recurrence rate, survival and functional results of 159 low rectal<br>cancer patients retrospectively, who had been performed 75 sphincter saving resections<br>(SSR) and 84 abdomino-perineal resections(APR) during July 1989 to December 1994.<br>The local recurrence rate was 9.3% in SSR and 8.3% in APR group, while systemic<br>recurrence rate was 20.5% and 16.7%, respectively(p>0.05). Three year survival rate was<br>70% in SSR and 85% in APR group. Comparing with Dukes'stage, it was 69%, 89% in<br>Dukes'B and 63%, 84% in Dukes'c stage, respectively(p>0.05). In respect to the number<br>of metastatic lymph node,3 year survival rate was 80%,95% in Nl group(≤3 metastatic<br>lymph nodes) and 61%,72% in N2 group(≥4 metastatic lymph nodes),<br>respectively(p>0.05). According to the distal resection margin(DRM), it was 100% in<br>group 1(1 cm≤DRM<2 cm), 63% in group 2(2 cm≤DRM < 3 cm) and 72% in group<br>3(DRM≥ 3 cm), respectively(p>0.05). Voiding dysfunction was developed 36.0% of SSR<br>and 28.6% of APR postoperatively. Erectile and ejaculatory dysfunction rate was 33.3%,<br>66.7% of SSR and 58.8%, 88.3% APR group respectively, There were no significant<br>differences in recurrence rate, survival rate and functional results Between SSR and<br>APR group.<br>Conclusively, sphincter saving resection in low rectal cancer surgery did not seem to<br>affect survival or recurrence. A good functional outcome in the SSR suggests it to be a<br>procedure of choice, if possible.<br>