Sphincter saving surgery for rectal malignancy is not done in.:
A. Age over 50 yearsB. Lymph node involvement
C. Infiltration of lamina propria
D. More than 4 cm from anal verge
E. High grade tumor
Answer (D)
More than 4 cm from anal verge
The surgery for Rectal Carcinoma requires to assess
— Fitness for the operation
— The extent of the spread of tumour
Gastro-intestinal continuity
• The sphincter saving surgery (Anterior resection) done
for — Growth for upper 2/3rd of rectum(above 7.5 cm from anal verge)
— Even in lower third of rectum using stapling gun.
But in case of anaplastic Tumour which has high risk of local recurrence and
high local, spread, it is customary not to perform restorative operations
However, with histologic differentiation, using pre-and post-operative
radiation many more anaplastic tumours are treated by sphincter-sparing
procedure.
— Lymph node involvement indicates stage ‘c’, and anterior resection can
be done when spread is virtually upward path.
— Sphincter-saving procedure is not suitable for lower third, extensive, large tumours
— Sphincter-saving procedure is not suitable for lower third, extensive, large tumours
— Though in Geriatric age sphincter is weak and
patulous, is a relative contraindication.
Early morning spurious diarrhoea- is an important
feature of Rectal Ca.
Best palliative measure for
rectal Ca is rectal excision.
MCQ: For old, female (unfit for prolonged surgery) pt.
Hartman’s procedure is done
