[Use of various surgical procedures in rectal cancer]

In a consecutive personal series of rectal carcinoma treated for locoregional cure (n = 125) various surgical procedures were employed. 21 patients with a pT1 tumour remained without recurrence with local excision in 17, and with a major restorative excision in the remainder patients. Though only 7 (20%) of the pT2 tumours were selected for local excision, secondary amputation became necessary in 3 instances for nodal involvement. Nodal staging was successful in one third of the local excisions performed. Extension of low anterior (n = 54) to abdominotranssphincteric (n = 11) and abdominotransanal (n = 16) resections was useful for preservation of continence and for performing a major procedure instead of local excision, with satisfying results of locoregional cure. Abdominoperineal excision was the treatment of choice for large tumours lying below 6 cm (n = 15) or in patients with a patulous anus (n = 5).