{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:39:39Z","timestamp":1774262379640,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2002,12,24]],"date-time":"2002-12-24T00:00:00Z","timestamp":1040688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2003,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Standard treatment of rectal adenocarcinoma located 3\u20136 cm above anal verge is abdominoperineal resection. The objective was to evaluate feasibility, morbidity, and functional results of anal sphincter preservation after preoperative chemoradiation therapy and coloanal anastomosis in patients with rectal adenocarcinoma located between 3 and 6 cm above the anal verge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 17 males and 15 females with a mean age of 54.8\u2009\u00b1 15.4 years. Tumors were located at a mean of 4.7\u2009\u00b1\u20091.1 cm above the anal verge. The mean tumor size was 4.6\u2009\u00b1\u20091.5 cm. All patients received the scheduled treatment. Twenty\u2010two patients underwent coloanal anastomosis with the J pouch; 10 underwent straight anastomosis. Average surgical time was 328.7\u2009\u00b1\u200943.8 min, and the average intraoperative hemorrhage was 471.5\u2009\u00b1\u2009363.6 ml. The mean distal surgical margin was 1.3\u2009\u00b1\u20090.6 cm. Five patients (15.6%) received a blood transfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Major complications included coloanal anastomotic leakage (three); pelvic abscess (three), and coloanal stenosis (two). Tumor stages were as follows: T0\u20132,N0,M0\u2009=\u200912; T3,N0,M0\u2009=\u20099; T1\u20133,N+,M0\u2009=\u20099, and T1\u20133,N0\u20133,M+\u2009=\u20092. Diverting stomas were closed in 30 patients. Median follow\u2010up was 25 months. Recurrences occurred in four patients and were local and distant (n\u2009=\u20091) and distant (n\u2009=\u20093). Anal sphincter function was perfect (n\u2009=\u200920), incontinent to gas (n\u2009=\u20093), occasional minor leak (n\u2009=\u20092), frequent major soiling (n\u2009=\u20093), and colostomy (n\u2009=\u20092).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with locally advanced rectal cancer located 3\u20136 cm from anal verge who are traditionally treated with abdominoperineal resection, preservation of anal sphincter after preoperative chemoradiation therapy plus complete rectal excision with coloanal anastomosis is feasible and is associated with acceptable morbidity and no mortality. J. Surg. Oncol. 2003;82:3\u20139. \u00a9 2002 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.10185","type":"journal-article","created":{"date-parts":[[2002,12,25]],"date-time":"2002-12-25T21:00:45Z","timestamp":1040850045000},"page":"3-9","source":"Crossref","is-referenced-by-count":41,"title":["Anal sphincter preservation in locally advanced low rectal adenocarcinoma after preoperative chemoradiation therapy and coloanal anastomosis"],"prefix":"10.1002","volume":"82","author":[{"given":"Pedro","family":"Luna\u2010P\u00e9rez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sa\u00fal","family":"Rodr\u00edguez\u2010Ram\u00edrez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddi","family":"Hern\u00e1ndez\u2010Pacheco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos","family":"Guti\u00e9rrez de la Barrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Labastida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,12,24]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"388","article-title":"Morbidity and mortality following abdominoperineal resection for low rectal cancer","volume":"53","author":"Luna\u2010P\u00e9rez P","year":"2001","journal-title":"Rev Invest Clin"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800691019"},{"key":"e_1_2_1_4_2","first-page":"333","article-title":"A prospective evaluation of distal margins in carcinoma of the rectum","volume":"175","author":"Vernava AM","year":"1992","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800700305"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1245\/aso.2001.8.7.611"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950801)76:3<388::AID-CNCR2820760307>3.0.CO;2-Y"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234128"},{"key":"e_1_2_1_9_2","first-page":"205","article-title":"The surgeon as prognostic factor for local recurrence and survival in the anal sphincter preservation for mid\u2010rectal cancer","volume":"51","author":"Luna\u2010P\u00e9rez P","year":"1999","journal-title":"Rev Invest Clin"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199002000-00011"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810344"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199704033361402"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010580"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199103143241101"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-001-0071-y"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730222"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730223"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/014107688808100904"},{"key":"e_1_2_1_20_2","first-page":"31","article-title":"Modified clearing technique to identify lymph node metastases in post\u2010irradiated surgical specimens from rectal adenocarcinoma","volume":"27","author":"S\u00e1nchez W","year":"1996","journal-title":"Arch Med Res"},{"key":"e_1_2_1_21_2","first-page":"81","volume-title":"American Joint Committee on Cancer. 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