Current use of sphincter-saving excision in the radical treatment of rectal cancer.
The author examines the recent increased use of sphincter-saving forms of excision to treat carcinomas of the middle third and upper part of the lower third of the rectum. This trend has been due chiefly to technical innovations--especially the introduction of the circular stapler, which has extended the downward reach of low anterior resection--and the willingness to accept a distal margin of clearance in resections of 2.0 to 2.5 cm instead of 4 to 5 cm. Published data show that these innovations are associated with a low operative mortality and that satisfactory anorectal function can be retained. Insufficient length of follow-up, however, has made it impossible so far to calculate valid long-term survival rates and the high incidence of local recurrence in some reports has been disturbing.
D001003:Anal Canal / Q000000981:diagnostic imaging / Q000502:physiology; D003125:Colostomy; D006801:Humans; D008297:Male; D008722:Methods; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011859:Radiography; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000000981:diagnostic imaging / Q000601:surgery; D013528:Surgical Staplers