title: Abdominoperineal resection: Treatment of choice for carcinoma of the rectum.
abstract: Abdominoperineal resection cure adenocarcinoma of the rectum was performed in 62 patients between 1965 and 1969 at the Winnipeg General Hospital. Mean age was 64, ranging from 41 to 83; 40 patients were male and 22 female. Distribution by Dukes' staging was: A, 11; B, 28; C, 23. Complications occurred in 22 patients (35%). Average hospital stay was 29 days, 27 days in uncomplicated patients and 36 days in those with complications. There were two deaths, a 3.2% operative mortality rate. Sixty of the 62 patients were available for 5-year followup. Crude survival rate was 52%: A, 91%; B, 59%; C, 25%. Two patients died of an operation that permanently cured three patients in whom disease had spread beyond local confines. Abdominoperineal resection offered a 52% 5-year survival rate, increased the rate of cures in the unstaged patient by at least 5% over that afforded by local therapy, gave a 14% chance of cure in stage C disease compared with 0% with local therapy, and, compared with local therapy, was at least 67% more likely to offer cure than to kill in the event of disease spread to regional lymph nodes.
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008722:Methods; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*