title: [Causes of local recurrence after curative surgery for rectal cancer].
abstract: The rate of local recurrence (LR) has been 20-40% after resective surgery for rectal cancer by the traditional - Miles or Dixon - operative technics. The authors performed curative resection in 358 patients with rectal cancer in a 10 year period (01.01.1990 - 31.12.2000) in the Surgical Department of Szeged University. Since 01.01.1996 the authors changed this type of surgery for the Heald technics (total mesorectal excision - TME - with sharp dissection, using the UltraCision device) for the surgical treatment of middle or lower third rectal cancer. To compare the results of the two procedures, the authors analysed their material in two periods: Period I: 01.01.1991 - 31.12.1992: 62 patients operated on with the traditional operative technics; LR 15% within 2 years after surgery. Period II: 01.01.1997 - 31.12.1998: 78 patients operated on with the Heald technics (TME with sharp dissection); LR 6.4% within 2 years after surgery. Based on their results, the authors found that the modern operative technics by Heald, used in the second period of the study, was a relevant factor decreasing LR from 15% to 6.4%, while the gender, age of the patients, ratio of the abdominoperineal extirpation versus anterior resection (APRE/AR) and the free margin of more than 3 cm proved to be irrelevant.
authors.affiliation: Sebészeti Klinika, Szegedi Tudományegyetem Altalános Orvosi Kar, Szeged 6720, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Hôhn
authors.forename: László
authors.initials: L
authors.lastname: Varga
authors.forename: Gellért
authors.initials: G
authors.lastname: Baradnay
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Simonka
authors.forename: Tibor
authors.initials: T
authors.lastname: Géczi
authors.forename: Ferenc
authors.initials: F
authors.lastname: Nagy
authors.forename: Tamás
authors.initials: T
authors.lastname: Molnár
authors.forename: Anikó
authors.initials: A
authors.lastname: Maráz
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Kahán
authors.forename: Adám
authors.initials: A
authors.lastname: Balogh
mesh_terms: D000367:Age Factors; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D017024:Chemotherapy, Adjuvant; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors