Mesorectal excision for rectal cancer

A series of 103 consecutive rectal cancers was prospectively documented. Laparotomy was performed in 78 patients of whom five did not undergo resection. Resection was considered curative unless there were liver metastases or biopsy-proven residual disease. Nine patients had a palliative resection. Thus 64 patients underwent a curative resection, 52 (81 per cent) of whom had an anterior resection of which 26 (46 per cent) were performed by trainees. There were three deaths after operation. Eight (14 per cent) patients developed a clinical anastomotic leak. Thirty patients were available for a minimum follow-up of 24 (mean 33, range 24-49) months. Four (13 per cent) patients developed distant recurrence. There were no isolated pelvic or anastomotic recurrences. One patient with distal recurrence may have had pelvic disease. The cumulative recurrence-free survival rate at 24 months was 84 per cent. These results support the suggestion that mesorectal excision may reduce local recurrence.