Abdominoperineal resection for carcinoma in the community hospital

All abdominoperineal resections for carcinoma of the rectum carried out 1963-1972 in two small community hospitals are reviewed. Seventy-six patients were found: males slightly outnumbered females; the average age was 61. There were 67 adenocarcinomas, 7 squamous cell carcinomas and one each of villous adenoma and carcinoid. Distribution of Dukes' classification was: A-20, B-26, C-21, D-9. In an average case the operative time was 3 hours, 25 minutes, 4 units of blood were used, and postoperative hospital stay was 30 days. Postoperative complications were recorded in over 50% of the patients with reoperation needed in 26% of all patients and delayed complications occurred in 41%. The operative mortality was 1.3%. Five year followup was possible in 40 of 43 patients; survival according to Dukes' classification was A-80%, B-53%, C-9% and D-25% with overall survival 45%.