ABSTRACT
Colo-rectal cancer is the most common gastrointestinal cancer in the world. One of the main problems in the treatment of rectal cancer is the development of local recurrences. This study was undertaken to evaluate the results of surgical treatment, with adjuvant and neo-adjuvant modalities, after the introduction of the concept of total mesorectal excision for lower and middle rectal cancer. 25 patients with rectal carcinoma were treated in the period between March 1998-till March 2003. They were 12 males with a mean age of 50.1 +/- 6 [average 28-81 years] and 13 females with the mean age of 52 +/- 3 [average 35-72 years]. 14 patients had a middle rectal tumor [7 +/- 2cm form the anal verge], underwent low anterior resection with a coloplasty reservoir reconstruction. Abdomino-perineal resection was done for 11 patients with lower tumours [3 +/- 1cm form the anal verge]. Fourteen patients received neo-adjuvant chemo-irradiation, 19 received adjuvant chemotherapy and only 7 received adjuvant postoperative radiotherapy. The operative complications included ureteric injury [1], urethral injury [1], and pre-sacral bleeding [2]. Immediate postoperative complications include 1 anastmotic leakage, and 1 pulmonary embolism [died and excluded from the study]. During the follow up period 2 patients developed pelvic recurrence [19 +/- 4 months], and 2 others developed liver metastases [18 +/- 6 months]. The overall, 3 years, disease free survival was 78.3%.Total mesorectal excision with neo-adjuvant and adjuvant treatment can improve the outcome for treatment of cancer rectum