Abstract
Sphincter-saving operation has been performed for the majority of the patients with rectal carcinoma at Osaka National Hospital. From 1975 to 1988, 222 patients with rectal carcinoma underwent curative anterior resections. Local recurrence was seen in 10 cases (4.5%), anastomotic recurrence in 6 cases and pelvic recurrence in 4 cases. Seven patients underwent a second resection, 6 of whom had anastomotic recurrences and a curative re-resection was performed in all these cases. The other one with a pelvic recurrence underwent noncurative re-resection. It was impossible to perform a re-resection for the other 3 cases with pelvic recurrence. The survival rate of the 7 cases who underwent re-resection was better than that of the 3 cases not undergoing re-resection. When performing anterior resection, adequate selection of the patients is important, especially in those with lower rectal carcinoma. Anterior resection should be performed with an adequate surgical margin and care should be taken to avoid the surgical implantation of tumor cells. Re-resection appears to be an effective treatment of local recurrence of rectal carcinoma after anterior resection.
