[Perineal infiltrates after amputation procedures in carcinoma of the rectum]

The authors present their experience with perineal infiltrates amputations on account of rectal carcinoma. In the course of 1986 in the Oncological Research Institute in Brno 58 patients with this diagnosis were hospitalized. After amputations three types of surgical complications were observed: 1. early inflammatory infiltrations, 2. late abscesses and 3. locoregional relapses of the primary tumour. Local relapses were detected first after five months and not later than three years after the radical operation. The authors draw attention to the fact that the first manifestation of the locoregional progress of the disease was a sensation of pressure or pain, which preceded the development of a resistance on the perineum and fever. The extent of tumourous infiltration was assessed by computed tomography. Reduction of locoregional relapses depends according to authors above all on a comprehensive approach to treatment. The usefulness of adjuvant irradiation is obvious. The authors assume that it is important to decide whether to irradiate before or after operation or to combine both methods and whether too combine irradiation with chemotherapy. Due to difficulties of therapeutic influencing of local relapses they emphasize above all the demand of respecting the rules of oncological surgery during the first operation.