Sphincter-saving surgery for low rectal cancer. The experience of the National Cancer Institute, Milano.
The treatment of tumors of the distal rectum continues to be a matter of great controversy among oncologic surgeons. There are increasingly promising indications that functionally conservative surgery may be a valid therapeutic alternative to conventional therapy in patients with tumours of the lower rectum, traditionally treated by abdomino-perineal resection and definitive colostomy. Many points are presently under evaluation and we want to discuss some of the most relevant topics that are now permitting to change the guide lines of therapy of this disease. Our view of the problem is based on a personal experience cumulated in fourteen years of activity in a specialized unit and this paper reports the main results of a complex and diversified study carried out during this period at the National Cancer Institute of Milan.
Leo
Ermanno
E
Colo-rectal Cancer Surgery Unit, Department of Surgery, National Cancer Institute, Via G. Venezian 1, 20133 Milan, Italy.
Belli
Filiberto
F
Andreola
Salvatore
S
Gallino
Gianfrancesco
G
Bonfanti
Giuliano
G
Vitellaro
Marco
M
Bruce
Caroline
C
Vannelli
Alberto
A
Battaglia
Luigi
L
D000005:Abdomen; D000047:Academies and Institutes; D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017024:Chemotherapy, Adjuvant; D003106:Colon / Q000601:surgery; D039021:Colonic Pouches; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010388:Pelvis; D011183:Postoperative Complications / Q000401:mortality; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D012007:Rectum / Q000601:surgery; D016896:Treatment Outcome