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The 4-portal technique decreases adverse effects in preoperative radiotherapy for advanced rectal cancer: comparison between the 2-portal and the 4-portal techniques.

Kiyomatsu T, Watanabe T, Muto T, Nagawa H

Department of Surgical Oncology, University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyokui, Tokyo, Japan 13-8655.

BACKGROUND: This study evaluated the difference of postoperative complications according to the radiation technique after preoperative radiotherapy for rectal cancer. METHODS: Among 224 patients with rectal cancer who underwent preoperative radiotherapy, 159 patients were treated with the 2-portal technique and 65 patients with the 4-portal technique. Comparison was performed between these 2 groups. RESULTS: The 5-year disease-free survival and local recurrence rate showed no difference between the 2 groups. There was also no difference in postoperative mortality. However, the 4-portal group had a significantly lower morbidity rate of 36.9% than the 2-portal group of 54.1% (P = .02). The rate of major complications that needed reoperation was also significantly lower in the 4-portal group (0%) than the 2-portal group (11.9%) (P = .01). The anastomotic leakage rate was significantly lower in the former (2.8% vs 20.0%, P = .033). CONCLUSION: The 4-portal technique is a better technique than the 2-portal technique for decreasing postoperative complications in preoperative radiotherapy for rectal cancer.

Published 10 September 2007 in Am J Surg, 194(4): 542-8.
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