Miles' resection for cancer of the rectum

Miles' resection is the optimal surgical operation for cancer involving the lowermost third of the rectum, although some surgeons question the wisdom of subjecting the patient to permanent colostomy and use fulguration as the alternative. In the author's series of 100 patients, the five-year survival rate was 41.6%. The operative mortality rate was 4%. The median distance of the cancer above the dentate line was 3 cm and the average distance was 4.6 cm. Fifty patients had Dukes' C lesions. Of the 100 patients, 95 had adenocarcinoma, 3 had squamous-cell carcinoma, 1 had a cloacogenic lesion, and 1 had melanocarcinoma. Complications were surprisingly few. Eleven patients had perineal recurrence. The relatively poor survival rate is attributed to anatomic limitations for radical surgical measures and to the spread of cancer cells by the time of operation. Regular check-up examinations are most effective in the prevention of rectal cancer.