We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

A Phase I Trial of Preoperative Radiation, Proctectomy, and Endoanal Reconstruction

Alfred M. Cohen, MD; Bruce D. Minsky, MD
Arch Surg. 1990;125(2):247-251. doi:10.1001/archsurg.1990.01410140125020.
Text Size: A A A
Published online


• The purpose of this study was to explore the feasibility of sphincter preservation in abdominoperineal resection candidates by combining high-dose preoperative radiation therapy with restorative proctectomy through an endoanal anastomosis. Radiation to the pelvis was given using a three- or four-field technique to 4680 cGy (180 cGy/d) with portals from the top of S1 to 2 cm below the anus. The tumor bed received an additional 360-cGy boost. Four to 6 weeks after radiation therapy was completed, the patients underwent radical surgery. Phase I results for 14 patients are presented. All surgical specimens had negative distal and lateral margins. Surgical complications included one small-bowel obstruction requiring reoperation at 3 weeks, one pulmonary embolism, and one partial disruption (30% of the circumference) of the anastomosis. Bowel control and function were excellent in 8 and good in 4 patients. Function was not yet assessable in the remaining 2 patients.

(Arch Surg. 1990;125:247-251)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.