[Surgical treatment of carcinoma of low rectum]

1230 cases of low rectal cancer were treated surgically from 1954 through 1990 with a resectability rate of 79.92% and a curative resectability rate of 63.98%. Among curative resections, abdomino-perineal excision accounted for 71.16% and sphincter-saving resection for 28.84%. Before 1980, 19.19% cases were treated with SSR and since 1980 it was raisen to 41.04%. In comparison of the results of group before 1980 with those since 1980, the mortality rate of curative resection was 1.56% and 0.99% respectively. The 5-year survival rate of curative resection (life table method) was 58.96% +/- 2.87% in APR and 80.39% +/- 5.06% in SSR before 1980, and 71.65% +/- 3.28% in APR and 83.82% +/- 3.46% since 1980. The local recurrence after curative resection was 13.57% in APR and 12.33% in SSR. The data showed that in properly selected cases, the outcome was better in SSR than in APR either in survival or in quality of life. The feasibility and reasonality of the SSR and the rules for selecting the operative procedures in low rectal cancer were discussed in detail.