Conference Papers

Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/6561

This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

Browse

Filters

20032

Settings

Author: search.filters.author.Perera, M.T.P.R.Has files: No

Search Results

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    The prevalence of urinary and sexual dysfunction following rectal excision
    (The College of Surgeons of Sri Lanka and SAARC Surgical Care Society, 2003) Perera, M.T.P.R.; Ratnayake, G.; de Silva, G.S.; Deen, K.I.
    INTRODUCTION: With improved survival following rectal excision for cancer and focus on nerve sparing operation, recent interest has centered on urinary and sexual dysfunction. OBJECTIVE: To identify the prevalence of urinary and sexual dysfunction in patients after rectal excision.METHODS: 43 patients (17 male, median age 55 years, range 24 to 74) underwent anterior resection (23), restorative proctocolectomy (13), abdomino-perineal excision (04), and rectal excision as part of subtotal colectomy (03). Structured interview was performed at least 03 months after stoma closure. Data were compared with age and gender matched controls. Statistical evaluation was by the McNemar test and test of proportions. Significance was assigned to a P value <0.05. RESULTS: Median (range) duration after operation was 28 months (8 - 84). Preoperatively, urinary function was similar in patients and controls. After operation, a significant number of patients had transient urinary dysfunction [urinary symptoms, pre vs post; 07 (16%) vs. 28 (65%) p< 0.05]. Long-term prevalence of poor stream and urinary hesitancy after operation were significant [poor stream; pre vs. post- 6 vs. 16: P=0.006 and hesitancy; pre vs. post - 6 vs. 18: P=0.004]. Sexual function was also significantly reduced in patients after operation [sexually active; pre vs. post- 29 vs. 17: P=0.004]. Fourteen (9 male,5 female) of 29 (48%) reported transient abstinence from sexual activity 6 months after operation whilst eight of 29 (27 .5%) reported more permanent abstinence (lack of interest-6, dyspareunia-1, erectile failure/ retrograde ejaculation - 7). CONCLUSION: Counseling regarding sexual and urinary function should be an integral part of the pre-operative work-up in patients having rectal excision
  • No Thumbnail Available
    Item
    Result of trans-anal inter-sphincteric resection(taisr) combined with total mesorectal excision (ime) and colo- anal anastomosis for distal rectal cancer
    (The College of Surgeons of Sri Lanka and SAARC Surgical Care Society, 2003) Deen, K.I.; Rajendra, S.; Hewavisenthi, J.; Perera, M.T.P.R.; Satheesan, B.
    INTRODUCTION: The treatment of distal rectal cancer is controversial. Most prefer abdomino-perineal excision because of the potential for wide local clearance. Staplers have limitations in restorative resection for distal rectal cancer. OBJECTIVE: To audit the results ofcombinning TAISR with TME and handsewn colo-anal anastomosis for distal rectal cancer. METHODS: I 08 Patients (45 male, median age 59 years, range -22-87) with rectal cancer underwent abdomino-perineal resection -15 ( 14%), Hartmann's procedure - 7 (6.5%), anterior resection -39 (36%) and anterior resection or total colectomy with TAISR and colo-anal anastomosis -47 (43.5%). TAISR was undertaken for tumours between O and 7 ems from the anal verge for rectal cancer with familial polyposis. Data sought were; overall survival, local clearance (RO- clear margins; R l-at least one involved margin) and local recurrence at 24 month median follow up (range- 5 -89 months). Data in the TAISR group were compared with the rest by the test for proportions. Significance was assigned to p<0.05. RESULTS: For the entire group, operative 30-day mortality was 4.6%. Overall disease related mortality at 24 months was 18%. For the entire group, curative resection (RO) was achieved in 93(86%) { TAISR- 39 of 47 (83%) vs. resection without TAJSR- 54 of61(88.5%)- P>0.05}. Overall, local recurrence was seen in 8 (7.4%) {TAISR - 4 of 47 (8.5%) vs. resection without TAISR- 4 of 61 (6.5%). CONCLUSION: There was no significant difference in achievement of free resection margins and local recurrence, in the-short-term, employin anal inter-sphincteric resection with TME for distal rectal cancer co with resection for proximal rectai cancer. Trans-anal inter-sphincteric r with TME for distal rectal cancer is safe in trained hands and should preferred choice in surgical management of distal rectal cancer.