AN ASSESSMENT OF DEVELOPING SURGICAL PRACTICE OF RECTAL CANCER IN PAKISTAN WITH REFERENCE TO COMPLETE MESO-RECTAL ELIMINATION

Objective: This study is designed to strive for the elaboration of presentation and pathology of rectal cancer, and to assess the indigenous experience after complete mesorectal elimination at a basic care hospital.

Methodology: To take an account of carcinoma rectum, researchers selected a sample of (200) patients which observed mesorectal excision at Allied Hospital, Faisalabad (February to August 2017). These cases reported through outpatient and in emergency departments of the hospital. We conserved the demographic history of each patient and maintained all the related information along with variables, as medical performances and demonstrations, the severity of tumour with a specific location, TNM appearance, and Duke's presentation. Additionally, we also secure the documentation of their surgical process and all those complications which appeared for further considerations during the time of treatments. We conducted all this documentation on proformas for certification. During the process of follow up session, we took the examination of each patient at two months for the first year, then for the next three years, we submitted the follow up at the interval of every four months and annually subsequently.

Results: The findings of the research reported almost the same ratio (1.6: 1) of male to female. The study observed age of the patients from (14 – 70) years. We determined the site of tumour at upper one third as (25%), at the middle, one third was (30%) and lower one third was (45%). A great margin of patients that was more than (62%) belonged to Dukes B Group. We did not observe any death case prior to the operation in the course of study, though, the study recorded complications in a total number of fifty-nine (29.5%) patients. These complications mainly related to colostomy (13.0%). We monitored (5%) patients with wound infection in abdomen, anastomotic dehiscence in (1.0%), (5%) patients with infection in their urinary tract, and impotence appeared in (1.5%). Twenty percent patients reported local recurrence.

Conclusion: This research claims mesorectal excision as a safe and reasonable technique for rectal cancer operation with feasible perioperative illness and has satisfactory local disease control.

Keywords: Rectal Cancer, Total Meso-rectal Excision, Presentation, and Outcome.