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• W2035300089 abstract "La chirurgie du cancer du bas rectum a deux impératifs ; obtenir des marges saines et limiter les séquelles fonctionnelles. La préservation ou non du sphincter est donc au centre du choix thérapeutique. Des marges histologiques saines distales et circonférentielles de plus de 1 mm assurent un résultat oncologique correct. Ces marges dépendent du stade TNM, du siège de la tumeur, de la réponse à la radiochimiothérapie et du type de chirurgie. La technique de résection intersphinctérienne utilise ces marges étroites pour conserver le sphincter. Cette technique obtient des résultats oncologiques satisfaisants, un taux de marge circonférentielle envahie de 5 à 11 % et permet une bonne continence chez la moitié des patients. L’amputation abdomino-périnéale extra-lévatorienne offre des résultats oncologiques également corrects mais impose une stomie définitive. Cette stomie définitive altère plusieurs domaines de la qualité de vie lorsqu’elle est placée au niveau abdominal classique mais pas lorsqu’elle est placée au niveau périnéal.The two goals of surgery for lower rectal cancer surgery are to obtain clear “curative” margins and to limit post-surgical functional disorders. The question of whether or not to preserve the anal sphincter lies at the center of the therapeutic choice. Histologically tumor-free distal and circumferential margins of > 1 mm allow a favorable oncologic outcome. Whether such margins can be obtained depends of TNM staging, tumor location, response to chemoradiotherapy and type of surgical procedure. The technique of intersphincteric resection relies on these narrow margins to spare the sphincter. This procedure provides satisfactory oncologic outcome with a rate of circumferential margin involvement ranging from 5% to 11% while good continence is maintained in half of the patients. The extralevator abdominoperineal resection provides good oncologic results, however this procedure requires a permanent colostomy. A permanent colostomy alters several domains of quality of life when located at the classical abdominal site but not when brought out at the perineal site as a perineal colostomy." @default.
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• W2035300089 date "2007-11-01" @default.
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• W2035300089 title "Prise en charge thérapeutique et étude de la survie de 952 cas de glioblastome incidents, en 2004, en France, sous l'égide de l'ANOCEF, de la SFNC et de la SFNP" @default.
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