1996 Volume 49 Issue 10 Pages 1247-1255
Patients with rectal cancer were divided into those treated in the early stage from 1975 to 1983 and the late stage from 1984 to 1990, and were compared with regard to the type of surgery and prognosis. Recently, the purpose of surgery has been radically extended resection with functional preservation of organs such as the sphincter. When rectal cancer (curability A and B) were treated surgically, the survival rate was greater in the late stage than the early stage, and significant improvement was observed for stage III a (curability A). These results were predominantly attributed to progress in operative procedures such as lymph node disection and radical resection of metastatic lesion. Since extended resection has revealed the mode of lymph node metastasis for rectal cancer, lateral Bisection has become important and has been done more frequently. Sphincter preserving operations have become widespread and are now performed in about half of the patients with cancer of the lower rectum. These procedures are not associated with worse prognosis than abdominoperineal resection. A major future task in the treatment of rectal carcinoma is to establish multidisciplinary therapy for stage 1ff b, for which prognosis has not improved, especially lateral lymph node metastasis positive cases. In addition, it may be necessary to consider the compatibility of resection and autonomic nerve preservation.
