[Conservative surgery in the treatment of rectal tumors. Our experience, 1986-1997].
OBJECTIVE
Our institution's experience with low anterior resection for primary rectal cancer was reviewed to determine cancer treatment results and to identify risk factors for pelvic recurrence.


METHODS
Ninety-two patients treated for primary rectal cancer between 1986 and 1997 were studied retrospectively. All cases was classified according to Astler-Coller. Median follow up was 46 months.


RESULTS
Actuarial 5-year survival for all patients was 79%. Among 28 patients who relapsed, only 9 pelvic recurrence was detected with an actuarial rate of 15% at 5 years. Lymph nodes involvement were associated with increased risk for pelvic recurrence.


CONCLUSIONS
Low anterior resection permitted by circular stapler provides good treatment for mid-rectal cancers and for some distal rectal cancers. Pelvic recurrence is not correlated with neoplasm localization, T stage and short distal resection margins, but only with the presence of lymph nodes involvement. This result increase the value of the hypothesis that search the pelvic recurrence origin in a extra-parietal disease respect anastomotic disease.


CONCLUSIONS
Fundamental to prevent pelvic recurrence is the surgical technique that have to remove lymph node en bloc with the rectum doing a dissection along the endopelvic fascia to Denonvillers fascia so to take away completely the mesorectum.
Cerroni
M
M
Clinica Chirurgica Generale e Toracica, Ospedale S. Maria, Terni.
Droghetti
A
A
Avenia
N
N
Palumbo
M
M
Marianeschi
P M
PM
Daddi
G
G
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018253:Adenoma, Villous / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors