eP400 Anterior Resection in Rectal Cancer: A 17 year cohort study

Aims Anterior Resection (AR) with TME offers sphincter saving surgery for low, mid & upper rectal cancers. AR has comparable results (cancer free resection & improved quality of life) to patients undergoing APR, APER or Hartmann’s procedure. The aim of this study is to evaluate post-operative outcomes in AR’s performed at a single centre. Methods A cohort study collated demographic and post-operative outcome data in all AR’s performed at a single-centre from January 2007 to February 2025. APR, APER and Hartman’s CRC resections were recruited as controls. Results AR(n=469) Non-AR(n=233) Mann-Whitney-U(p-value) Age (yrs) 68.1±0.5 71.6±0.8 NS Sex (M:F) 285:184 139:94 NS ASA 2 2 NS Wt(kg) 78.4±0.8 76.8±1.3 NS BMI(kg/m2) 27.0±0.2 26.9±0.4 NS Op-time(mins) 236.3±3.9 209.6±5.5 <0.0001 Emergency(n) 2 76 <0.0001 Lap(n) 341 103 <0.0001 LOS(days) 7±3.5 12 ± 5 <0.0001 LB-length(mm) 224.0±7.0 267.7±10.9 <0.0001 90-D-mortality(n) 8 18 NS Complications(n) Leaks 38 0 NS Ileus 67 49 NS HAP 45 23 NS Wound infections 29 39 NS Sepsis 21 21 NS Collections 38 15 NS Survival rates(%) 1styear 95.6 86.1 Logrank 4thyear 82.3 67.0 8thyear 69.6 55.3 p<0.0001 12thyear 61.9 45.4 (uncensored) 16thyear 48.1 36.5 Conclusion AR was associated with prolonged operative times (adoption of laparoscopic techniques) but shorter hospitalization than non AR resections. There were no differences in early post operative complications & early mortality. AR had better long term survival, this could be explained by reduced emergency cases.