Local recurrence and the EEA stapler--examination of a predictive model.
The overall local recurrence rate following resection of colorectal cancer with restoration of continuity with staples in Wellington was 24%. Nine of 11 patients with local recurrence following resection of rectal tumours had distant metastases at the time of diagnosis of their local recurrence. Using a predictive model to retrospectively estimate the probability of local recurrence it was found that nine of these 11 patients would have been expected to have had a lower local recurrence rate had they undergone abdominoperineal resection of the rectum initially. Since local recurrence is simply a local manifestation of systemic disease in 90% of patients, however, it is suggested that patients would prefer restoration of bowel continuity in preference to rectal excision and stoma formation, there being such little survival advantage for the latter procedure. The utility of the predictive model is therefore questioned.
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D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011336:Probability; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013528:Surgical Staplers; D013997:Time Factors