Local resection for the treatment of low rectal carcinoma:report of 54 patients / 中国普通外科杂志

ABSTRACT

Objective To evaluate outcome of local excision of rectal cancer for curative purpose.Methods Fifty four patients with low rectal carcinoma undergoing local excision from 1975 to 2000 were analyzed retrospectively.Results In this study, 44 patients underwent trans anal resection (TAR), 6 did trans sacral resection (TSR), 2 each did trans sphincteric local resection (TSLR) and trans vaginal resection (TVR). Most tumors were within 8 cm from the anal verge, and the average distance was 6 6 cm in TSR, 5 2 cm in TVR, 4 7 cm in TAR and 4 5 cm in TSLR, respectively. Most tumors (89%, 48/54) were less than 3 cm in diameter, six tumors (11%) were larger than 3 cm. The mean size of tumor was 3 5 cm in TSR group, 3 5 cm in TSLR, 2 5 cm in TAR, and 2 5 cm in TVR. Tumors were in T 1 stage in 46 patients and in T 2 in 8 patients. Postoperative complications included anastomosis leakage in one, sphincteric dysfunction in 2, and anal bleeding in 2. Eight patients (15 1%) recurred locally during the period of postoperative follow up, at a mean time of 42 2 months ranging 10 to 84 months. Five, ten year overall survival rates were 86 7% (39/45) and 69 2% (27/39)for T 1 tumor, and 75 0% (6/8) and 33 3% (2/6) for T 2 tumor, respectively.Conclusions Local excision of rectal cancer is of less injury and early recovery in properly selected patients while not at the expense of long term survival.