Current thoughts on the surgical treatment of rectal cancer

From August, 1971 to May, 1974, 52 cases of rectal cancer belonging to different groups, according to Mason's classification, were seen at the First Surgical Department, University of Athens Medical School. In the majority of the cases the tumor was removed by combined abdominoperineal resection; the variety of other surgical methods in the treatment of rectal cancer are discussed. Emphasis is focused on certain important technical aspects in the surgery of rectal cancer: 1. the need for thorough preoperative preparation of the bowel; 2. the ligation of the inferior mesenteric artery at its origin from the aorta; 3. the intraluminal infusion of cytotoxic agents into the tumor-bearing segment after ligation of the inferior mesenteric vein; 4. the idea of the intra-arterial regional chemotherapy, during the operation; 5. the demarcation of the area with radiopaque clips for acute postoperative radiation,when residual tumor is left behind. The authors consider adherence to the above technical details critical in achieving good surgical results.