[Causes and management of local tumor recurrence after low resection of the rectum]

The postoperative course of 64 patients resected with EEA stapler because of their midrectal cancer have been followed. 13 (20.3%) local tumor recurrence have been observed in the first 24 postoperative months. 5 patients could be rectum exstirpated at the reexploration, only colostomy was performed in 8 cases. All the inoperabel patients have died in a year, but 3 of the exstirpated ones overlived this time. A direct connection have been observed between the Dukes stadium and the differentiation of the tumor, the distance of the distal resection line from the lower end of the tumor and the probability of the local recurrence. No connection has been found between the distance of the tumor from the linea dentata and the local tumor recurrence. On the basis of the oncological observations the deep rectal resection can be performed only by tumors in stadium Dukes A and B, if the tumor is well differentiated, there are no signs for local propagation or lymph node metastases, and more then 2 cm distal distance can be kept by the resection from the lower and of the tumor. In all other cases the rectum exstirpation must be the method of choice.