[The treatment of rectal cancer--the optimizing possibilities]

The authors studies 280 rectal cancers treated in the first surgical clinic of Iaşi in the period 1981-1994. Although surgery is the main treatment of these tumors, it cannot be and it must be not used alone. Surgery must be associated with radio- and chemotherapy, because is the only way possible to increase the number of resections for rectal tumors and the survival rate. For the 263 tumors operated the resectability was 73, 5%: Milles's operation 101 (36, 7%), Dixon's operation 81 (30, 79%), other operation 91 (33, 11%). We consider that Dixon's operation is the best choice for the tumors in the stages A and B of Dukes classifications. Preoperative radiotherapy can influence the tumor volume (downstaging) and decrease local recurrences to about 10-15%. Surgery alone must be practiced only in emergencies. Postoperative chemotherapy is mandatory and it reduces local recurrences and delays metastasis evolution.