[Comparative studies of local recurrence following sphincter preserving anterior rectal resection and primary rectal...

From May 1980-May 1983, 57 patients suffering from carcinoma of the distal part of the sigmoid colon and the rectum located 7 to 20 cm above the anus had anterior resections, with continuity being restored. 19 local recurrences could be demonstrated by a follow-up made in November 1983. In a group of 23 cases where the tumour was located between 7 to 10 cm above the anus 12 recurrences (56%) were found, which were not caused by the degree of malignancy or carcinous invasion of the intestinal wall. In the other group of 27 cases with the tumour located between 11 and 15 cm above the anus we found 6 local recurrences (22%), mostly in high risk tumours. Comparing the total recurrence rate of 36% within 34 months after anterior resection with a mortality rate of 18% after exstirpation of the rectum (18% within 36 months from 986 patients between 1960 to 1981) we came to the conclusion that tumours situated lower than 15 cm from the anus should only be extirpated, not resected.