Diseases of the Colon & Rectum

, Volume 37, Supplement 2, pp S35–S41 | Cite as

Low rectal cancer—What is the choice?

  • G. Fegiz
  • M. Indinnimeo
  • P. Gozzo
  • E. Del Grande
  • S. Cataldi
  • S. Brozzetti
Original Contributions


In patients operated on for low rectal cancer, the functional results, disease recurrence, and survival have been evaluated with respect to the type of surgery performed. Particular attention was paid to analysis of the pathologic aspects, considered in our opinion, as risk factors for recurrence. The investigation was carried out on 131 patients, of whom 70 received anterior resection, 55 abdominoperineal resection, and 6 local treatment. Abdominoperineal resection was carried out in more advanced disease. Postoperative mortality was 2.1 percent after anterior resection and 0 after abdominoperineal resection or local treatment. Follow-up, carried out in 96 patients (44 anterior resections, 46 abdominoperineal resections, and 6 local treatments), ranged from 12 to 84 (mean, 33.3) months. Recurrence rate was 53.3 percent after abdominoperineal resection and 28.9 percent after anterior resection. Recurrence appears not be related to the treatment performed, but rather depend on certain aspects of the neoplasm such as diameter exceeding 5 cm, extraparietal infiltration, lymphangitis, and tumor indifferentiation. We observed anastomotic recurrence in 28.6 percent of patients with a margin of less than 2 cm. An intensive follow-up scheme enabled us to recognize this type of recurrence early and to reoperate with radical intent. One year after anterior resection functional results were encouraging. No severe incontinence was reported. Local treatment was performed in carefully selected patients (T1, N0) and no cases of mortality or recurrence were observed.

Key words

Low rectal cancer Anterior resection Abdominoperineal resection Follow-up in rectal cancer Risk factors in rectal cancer Anal function after coloanal and low colorectal anastomosis 


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Copyright information

© American Society of Colon and Rectal Surgeons 1994

Authors and Affiliations

  • G. Fegiz
    • 1
  • M. Indinnimeo
    • 1
  • P. Gozzo
    • 1
  • E. Del Grande
    • 1
  • S. Cataldi
    • 1
  • S. Brozzetti
    • 1
  1. 1.I Institute of Surgical ClinicUniversity “La Sapienza”RomeItaly

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