[Rectosigmoid cancer. Report on 442 cases]

Between 1961 and 1980 442 patients with rectosigmoidal carcinoma were treated. As preparation for operation and technique changed in 1974, two groups were formed: those between 1961 and 1973 (n = 196) and those from 1974 to 1980 (n = 246). The average duration of treatment was reduced from 63 to 36 due to out-patient preoperative measures. Resection (continent and incontinent) was the standard procedure, with local transanal excision in occasional cases. Continence preserving resection increased two-fold when compared with amputation in the second period. The death rate in 337 resected tumours was 18.5% and could be reduced from 22% to 16%. The death rate unrelated to operation remained unchanged whereas the operative mortality after a curative procedure fell from 11% to 2%. The reduction in death rate directly due to the operation was particularly noticeable in the simultaneous abdomino-perineal rectal amputation. Only one out of 18 patients operated on in this way died due to massive pulmonary embolism.