Surgical Options in Rectal Cancer

  • Carlo W. Taat
  • C. Paul Maas
  • Willem-Hans Steup
  • Cornelis J. H. van de Velde


Despite advances made in diagnostic, anaesthetic and operative technology over the past five decades, results after curative surgery for rectal cancer have not improved, reflected by a reported local failure rate varying from 4% to over 30%, and an overall survival of less than 50% [1]. Although figures on recurrence rate may be partially dependent on the length of follow-up, and the diagnostic tools and the diagnostic criteria employed, such variation is unique in cancer surgery [18].


Local Recurrence Rectal Cancer Total Mesorectal Excision Local Recurrence Rate Rectal Carcinoma 
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  1. 1.
    Abulafi AM, Williams NS (1994) Local recurrence of colorectal cancer: the problem, mechanisms, management and adjuvant therapy. Br J Surg 81: 7 – 19PubMedGoogle Scholar
  2. 2.
    Adam IJ, Mohamdee MO, Martin IG et al. (1994) Role of circumferential margin in-volvement in the local recurrence of rectal cancer. Lancet 334: 707 – 711Google Scholar
  3. 3.
    Amato A, Pescatori M, Butti A (1991) Local recurrence following abdominoperineal excision and anterior resection for rectal carcinoma. Dis Colon Rectum 34: 317 – 322PubMedGoogle Scholar
  4. 4.
    Anderberg B, Enblad P, Sjödahl R, Wetterfors J (1983) The EEA stapling device in anterior resection for carcinoma of the rectum. Acta Chir Scand 149: 99 – 103PubMedGoogle Scholar
  5. 5.
    Ayoub SF (1978) Arterial blood supply of the human rectum. Acta Anat 100: 317 – 327PubMedGoogle Scholar
  6. 6.
    Bacon HE, Khubchandani IT (1964) The rationale of aortoiliopelvic lymphadenectomy and high ligation of the inferior mesenteric artery for carcinoma of the left half of the colon and rectum. Surg Gynecol Obstet 119: 503 – 508PubMedGoogle Scholar
  7. 7.
    Bacon HE, Sauer I (1950) Surgical treatment of cancer of the lower bowel. Cancer 3: 773 – 778PubMedGoogle Scholar
  8. 8.
    Bacon H, Dirbas F, Myers T, Ponce de Leon F (1958) Extensive lymphadenectomy and high ligation of the inferior mesenteric artery for carcinoma of the left colon and rectum. Dis Colon Rectum 1: 457 – 465PubMedGoogle Scholar
  9. 9.
    Baron PL, Enker WE, Zakowski MF, Urmacher C (1995) Immediate vs salvage resection after local treatment for early rectal cancer. Dis Colon Rectum 38: 177 – 181PubMedGoogle Scholar
  10. 10.
    Bentzen SM, Balslev I, Pedersen M et al. (1992) Time to loco-regional recurrence after resection of Dukes’ B and C colorectal cancer with and without adjuvant postoperative radiotherapy. A multivariate regression analysis. Br Cane 65: 102 – 107Google Scholar
  11. 11.
    Bergman L, Solhaug JH (1986) Posterior trans-sphincteric resection for small tumours of the lower rectum. Acta Chir Scand 152: 313 – 316PubMedGoogle Scholar
  12. 12.
    Best RR, Blair B (1949) Sphincter preserving operations for rectal carcinoma as related to the anatomy of the lymphatics. Ann Surg 130: 538 – 576Google Scholar
  13. 13.
    Beynon J, Mortensen NJ, Foy DM et al. (1989) Preoperative assessment of mesorectal lymph node involvement in rectal cancer. Br J Surg 76: 276 – 279PubMedGoogle Scholar
  14. 14.
    Bognel C, Rekacewicz C, Mankarios H et al. (1995) Prognostic value of neural invasion in rectal carcinoma: a multivariate analysis on 339 patients with curative resection. Eur J Cancer 31A: 894 – 898PubMedGoogle Scholar
  15. 15.
    Bonenkamp JJ, Songun I, Hermans J et al. (1995) Randomized comparison of morbidity after Dl and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 345: 745 – 748PubMedGoogle Scholar
  16. 16.
    Buess G, Kipfmüller K, Ibald R, Heintz A et al. (1989) Transanale endoskopische Mikrochirurgie beim Rectumcarcinom. Chirurg 60: 901 – 904PubMedGoogle Scholar
  17. 17.
    Bunt AMG, Hermans J, Smit VTHBM et al. (1995) Surgical/pathological-stage migration confounds comparisons of gastric cancer survival rates between Japan and Western countries. J Clin Oncol 13: 19 – 25PubMedGoogle Scholar
  18. 18.
    Carlsson U, Larson A, Ekelund G (1987) Recurrence rates after curative surgery for rectal cancer with special reference to their accuracy. Dis Colon Rectum 30: 431 – 436PubMedGoogle Scholar
  19. 19.
    Cawthorn SJ, Parums DV, Gibbs NM et al. (1990) Extent of mesorectal spread and involvement of lateral margin as a prognostic factor after surgery for rectal cancer. Lancet 335: 1087Google Scholar
  20. 20.
    Cedermark B, Johansson H, Rutqvist LE et al. for the Stockholm Colorectal Cancer Study Group (1995) The Stockholm I trial of preoperative short-term radiotherapy in operable rectal carcinoma. Cancer 75:2269–2275Google Scholar
  21. 21.
    Cohen AM, Winawer SJ (eds) (1995) Cancer of the colon, rectum and anus. McGraw-Hill, New York, p 583Google Scholar
  22. 22.
    Derksen EJ (1992) New aspects in diagnoses and treatment of rectal cancer. Academic Thesis, Free University, AmsterdamGoogle Scholar
  23. 23.
    Dixon AR, Maxwell WA, Thornton Holmes J (1991) Carcinoma of the rectum: a 10-year experience. Br J Surg 78: 301 – 311Google Scholar
  24. 24.
    Enker WE (1978) Surgical treatment of large bowel cancer. In: Enker WE (ed) Carcinoma of the colon and rectum. Yearbook Medical, Chicago, pp 97 – 100Google Scholar
  25. 25.
    Enker WE (1992) Potency, cure, and local control in the operative treatment of rectal cancer. Arch Surg 127: 1396 – 1402PubMedGoogle Scholar
  26. 26.
    Enker WE, Laffer UT, Block GE (1979) Enhanced survival of patients with colon and rectal cancer is based upon wide anatomic resection. Ann Surg 190: 350 – 360PubMedGoogle Scholar
  27. 27.
    Enker WE, Pilipshen SJ, Heilweil ML et al. (1986) En bloc pelvic lymphadenectomy and sphincter preservation in the surgical management of rectal cancer. Ann Surg 203: 426 – 433PubMedGoogle Scholar
  28. 28.
    Enker WE, Thaler HT, Cranor ML, Polyak T (1995) Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg 181: 335 – 346PubMedGoogle Scholar
  29. 29.
    Fändrich F, Schröder DW, Saliveros E (1994) Long term survival after curative resection for adenocarcinoma of the rectum. J Am Coll Surg 178: 271 – 276PubMedGoogle Scholar
  30. 30.
    Fielding LP (1988) Surgeon-related variability in the outcome of cancer surgery. J Clin Gastroenterol 10: 130 – 132PubMedGoogle Scholar
  31. 31.
    Fielding LP (1993) Colorectal carcinoma: mesorectal excision for rectal cancer (letter). Lancet 341: 471 – 472PubMedGoogle Scholar
  32. 32.
    Fisher ER, Turnbull RB (1987) The cytologic demonstration and significance of tumour cells in the mesenteric venous blood in patients with colorectal carcinoma. Surg Gynecol Obstet 100: 102 – 108Google Scholar
  33. 33.
    Gabriel W, Dukes C, Bussey H (1935) Lymphatic spread in cancer of the rectum. Br J Surg 23: 395 – 413Google Scholar
  34. 34.
    Gall FP, Hermanek P (1988) Cancer of the rectum - local excision. Surg Clin N Am 68: 1353 – 1365PubMedGoogle Scholar
  35. 35.
    Gastrointestinal Tumor Study Group (1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med 312: 1465 – 1472Google Scholar
  36. 36.
    Gerard A, Buyse M, Nordlinger B et al. (1988) Preoperative radiotherapy as adjuvant treatment in rectal cancer. Ann Surg 208: 606 – 614PubMedGoogle Scholar
  37. 37.
    Glass R, Ritchie J, Thyompson H, Mann C (1985) The results of surgical treatment of cancer of the rectum by radical resection and extended abdominoiliac lymphade¬nectomy. Br J Surg 72: 599 – 601PubMedGoogle Scholar
  38. 38.
    Goldberg PA, Nicholls RJ, Porter NH et al. (1994) Long-term results of a randomized trial of short-course low-dose adjuvant preoperative radiotherapy for rectal cancer. Reduc¬tion in local treatment failure. Eur J Cancer 30A: 1602 – 1606PubMedGoogle Scholar
  39. 39.
    Graham RA, Garnsey L, Jessup JM (1990) Local excision of rectal carcinoma. Am J Surg 160: 306 – 312PubMedGoogle Scholar
  40. 40.
    Griffiths JD, McKinna JA, Rowbotham HD (1973) Carcinoma of the colon and rectum: circulating malignant cells and 5 year survival. Cancer 31: 226PubMedGoogle Scholar
  41. 41.
    Grinnell RS (1942) The lymphatic and venous spread of carcinoma of the rectum. Ann Surg 116: 200 – 216PubMedGoogle Scholar
  42. 42.
    Grinnell RS (1954) Distal intramural spread of carcinoma of the rectum and recto¬sigmoid. Surg Gynecol Obstet 99: 421 – 430PubMedGoogle Scholar
  43. 43.
    Haas-Kock de D, Baeten C, Jager J et al. (1995) The prognostic significance of the lateral resection margin in rectal cancer. Presented at IKA 15th Anniversary International Congress Colorectal Cancer: From Gene to Cure, 9–11 February 1995, Academic Medical Center, AmsterdamGoogle Scholar
  44. 44.
    Harnsberger JR, Vernava AM, Longo WE (1994) Radical abdominopelvic: lymphade-nectomy historic perspective and current role in the surgical management of rectal cancer. Dis Colon Rectum 37: 73 – 87PubMedGoogle Scholar
  45. 45.
    Heald RJ (1988) The “Holy Plane” of rectal surgery. J Royal Soc Med 81: 503 – 509Google Scholar
  46. 46.
    Heald RJ (1991) Function preserving rectal surgery (letter). Dis Colon Rectum 34: 627 – 628Google Scholar
  47. 47.
    Heald RJ (1995) Invited lecture: rectal cancer: the surgical options Presented at IKA 15th Anniversary International Congress “Colorectal Cancer: From Gene to Cure”, February 9–11, 1995, Academic Medical Center, Amsterdam, The NetherlandsGoogle Scholar
  48. 48.
    Heald RJ (1995) Rectal cancer: the surgical options. Eur J Cancer 31A: 1189 - 1192PubMedGoogle Scholar
  49. 49.
    Heald RJ, Karanjia ND (1992) Results of radical surgery for rectal cancer. World J Surg 16: 848 – 857PubMedGoogle Scholar
  50. 50.
    Heald RJ, Ryall RDH (1986) Recurrence and survival after mesorectal excision for rectal cancer. Lancet 1: 1479 – 1482PubMedGoogle Scholar
  51. 51.
    Heald RJ, Husband EM, Ryall RDH (1982) The mesorectum in rectal cancer surgery - the clue to pelvic recurrence? Br J Surg 69: 613 – 616PubMedGoogle Scholar
  52. 52.
    Hermanek P (1982) Evolution and pathology of rectal cancer. World J Surg 6: 502 – 509PubMedGoogle Scholar
  53. 53.
    Hermanek P (1994) Local control and long-term prognosis. Results of the German Multicenter Study on Colorectal Cancer. Presentation to the European Society of Surgical Oncology. Joint Meeting of ESSO, BASO and CAO. Heidelberg, June 10, 1994Google Scholar
  54. 54.
    Herrera L, Villarreal JR (1992) Incidence of metastases from rectal adenicarcinoma in small lymph nodes detected by a clearing technique. Dis Colon Rectum 35: 783 – 788PubMedGoogle Scholar
  55. 55.
    Hojo K, Koyama Y (1982) Lymphatic spread and its value in rectal cancer. Am J Surg 144: 350 – 354PubMedGoogle Scholar
  56. 56.
    Hojo K, Sawada T, Moriya Y (1989) An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with adenocarcinoma of the rectum, compared with conventional lymphadenectomy. Dis Colon Rectum 32: 128 – 133PubMedGoogle Scholar
  57. 57.
    Horn A, Halvorsen JF, Morild I (1989) Transanal extirpation for early rectal cancer. Dis Colon Rectum 32: 769 – 772PubMedGoogle Scholar
  58. 58.
    Horn A, Halvorsen JF, Dahl O (1990) Preoperative radiotherapy in operable rectal cancer. Dis Colon Rectum 33: 823 – 828PubMedGoogle Scholar
  59. 59.
    Houbiers J, Brand A, van de Watering LMG et al. (1994) Randomized controlled trial comparing transfusion of leucocyte-depleted or buffy-coat-depleted blood in surgery for colorectal cancer. Lancet 334: 573 – 578Google Scholar
  60. 60.
    Isbister WH (1990) Basingstoke revisited. Aust NZ J Surg 60: 243 – 246Google Scholar
  61. 61.
    Isenberg J, Keller HW, Pichlmaier H (1995) Middle and lower third rectum carcinoma: sphincter saving or abdominoperineal resection? Eur J Surg Oncol 21: 265 – 268PubMedGoogle Scholar
  62. 62.
    Jones PF, Thomson HJ (1982) Long term results of a consistent policy of sphincter preservation in the treatment of carcinoma of the rectum. Br J Surg 67: 564 – 568Google Scholar
  63. 63.
    Karanjia ND, Schach DJ, North WRS, Heald RJ (1990) “Close shave” in anterior resec-tion. Br J Surg 77:510–512Google Scholar
  64. 64.
    Karanjia ND, Corder AP, Beam P, Heald RJ (1994) Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg 81: 1224 - 1226PubMedGoogle Scholar
  65. 65.
    Koyama Y, Moriya Y, Hojo K (1984) Effects of systematic lymphadenectomy for ade-nocarcinoma of the rectum. Jpn J Clin Oncol 14: 623 – 632PubMedGoogle Scholar
  66. 66.
    Krook JE, Moertel Ch, Gunderson LL et al. (1991) Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324: 709 – 715PubMedGoogle Scholar
  67. 67.
    Lee JF, Mauer VM, Block GE (1973) Anatomic relations of pelvic autonomic nerves to pelvic operations. Arch Surg 107: 324 – 328PubMedGoogle Scholar
  68. 68.
    Lloyd-Davies OV (1948) Radical excision of carcinoma of the rectum with conservation of the sphincters. Proc R Soc Med 41: 822 – 826Google Scholar
  69. 69.
    Localio SA, Eng K, Coppa GF (1983) Abdominosacral resection for midrectal cancer. Ann Surg 198: 320 – 324PubMedGoogle Scholar
  70. 70.
    MacFarlane JK, Ryall RDH, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet 341: 457 – 460PubMedGoogle Scholar
  71. 71.
    Marks G, Mohiuddin MM, Masoni L, Pecchioli L (1990) High dose radiation and full-thickness local excision. Dis Colon Rectum 33: 735 – 759PubMedGoogle Scholar
  72. 72.
    Marsh PJ, James RD, Schofield PF (1995) Definition of local recurrence after surgery for rectal carcinoma. Br J Surg 82: 465 – 468PubMedGoogle Scholar
  73. 73.
    Mason AY (1977) Trans-sphincteric approach to rectal lesions. Surg Ann 9: 171 – 194Google Scholar
  74. 74.
    McArdle CS, Hole D (1991) Impact of variability among surgeons on postoperative morbidity and mortality and ultimate survival. Br Med J 302: 1501 – 1505Google Scholar
  75. 75.
    McCall JL, Cox MR, Wattchow DA (1995) Analysis of local recurrence rates after surgery alone for rectal cancer. Int J Colorect Dis 10: 126 – 132Google Scholar
  76. 76.
    McDermott FT, Hughes ERS, Pihl E et al. (1985) Local recurrence after potentially curative resection for rectal cancer in a series of 1008 patients. Br J Surg 72: 34 – 37PubMedGoogle Scholar
  77. 77.
    Mettlin C, Mittelman A, Natarajan N et al. (1981) Trends in the United States for the management of adenocarcinoma of the rectum. Surg Gynecol Obstet 153: 701 – 706PubMedGoogle Scholar
  78. 78.
    Michelassi F, Block GE, Vannuci L, Montag A, Chappell R (1988) A 5-to 21-year follow-up and analysis of 250 patients with rectal adenocarcinoma. Ann Surg 208: 379 – 380PubMedGoogle Scholar
  79. 79.
    Michelassi F, Block GE (1992) Morbidity and mortality of wide pelvic lymphadenectomy for rectal adenocarcinoma. Dis Colon Rectum 35: 1143 – 1147PubMedGoogle Scholar
  80. 80.
    Michelassi F, Vannuci L, Alaya JA, Chappel R, Goldberg R, Block GE (1990) Local recurrence after curative resection of colorectal carcinoma. Surgery 108: 787 – 793PubMedGoogle Scholar
  81. 81.
    Miles WE (1908) A method of performing abdomino-perineal resection for carcinoma of the rectum and of the terminal portion of the pelvic colon. Lancet 11: 1812 – 1813Google Scholar
  82. 82.
    Miles WE (1923) Cancer of the rectum. Lettsomiam Lectures. Harrison and Sons, Lon-don, p 63Google Scholar
  83. 83.
    Minsky BD, Cohen AM, Enker WE, Mies C (1991) Sphincter preservation in rectal cancer by local excision and postoperative radiation therapy. Cancer 67: 908 – 914PubMedGoogle Scholar
  84. 84.
    Moran MR, James EC, Rothenberger DA, Goldberg SM (1992) Prognostic value of pos-itive lymph nodes in rectal cancer. Dis Colon Rectum 35: 579 – 581PubMedGoogle Scholar
  85. 85.
    Loreira LF, Hizuta A, Iwagaki H et al. (1994) Lateral lymph node dissection for rectal carcinoma below the peritoneal reflection. Br J Surg 81: 293 – 296Google Scholar
  86. 86.
    Moriya Y, Hojo K, Sawada T, Koyama Y (1989) Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection. Dis Colon Rectum 32: 307 – 315PubMedGoogle Scholar
  87. 87.
    Moriya Y (1993) Pelvic node dissection with autonomic nerve sparing for invasive lower rectal cancer: Japanese experience. In: Wanebo HJ (ed) Colorectal cancer. Mosby, St. Louis, p 274Google Scholar
  88. 88.
    Morson BC, Bussey HJR, Samoorian S (1977) Policy of local excision for early rectal carcinoma of the colorectum. Gut 18: 1045 – 1050PubMedGoogle Scholar
  89. 89.
    Moynihan BGA (1908) The surgical treatment of cancer of the sigmoid flexure and rectum: with special attention to the principles observed. Surg Gynecol Obstet 6: 463 – 466Google Scholar
  90. 90.
    Nelson H, Beart RW Jr (1993) Surgical management: optimal procedures and overall results. In: Wanebo HJ (ed) Colorectal cancer. Mosby, St. Louis, p 199Google Scholar
  91. 91.
    Neville R, Fielding LP, Amendola C (1987) Local tumor recurrence after curative re-section for rectal cancer: a ten hospital review. Dis Colon Rectum 30: 12 – 17PubMedGoogle Scholar
  92. 92.
    NIH Consensus Conference (1990) Adjuvant therapy for patients with colorectal cancer. JAMA 264: 1444 – 1450Google Scholar
  93. 93.
    Norgren J, Svensson JO (1985) Anal implantation metastasis from carcinoma of the sigmoid colon and rectuma risk when performing anterior resection with the EEA-stapler? Br J Surg 72: 602PubMedGoogle Scholar
  94. 94.
    Norstein J, Bergan A, Langmark F (1993) Risk factors for local recurrence after radical surgery for rectal carcinoma: a prospective multicentre study. Br J Surg 80 [Suppl]: S22Google Scholar
  95. 95.
    O’Connell MJ, Martenson JA, Wieand HS et al. (1994) Improving adjuvant therapy for rectal cancer by combining protracted infusion Fluorouracil with radiation therapy after curative surgery. N Engl J Med 331: 502 – 507PubMedGoogle Scholar
  96. 96.
    Pezim ME, Nicholls RJ (1984) Survival after high or low ligation of the inferior mes¬enteric artery during curative surgery for rectal cancer. Ann Surg 200: 729 – 733PubMedGoogle Scholar
  97. 97.
    Phillips RK, Hittinger R, Blesovsky L, Fry JS, Fielding P (1984) Local recurrence following “curative” surgery for large bowel cancer: I. The overall picture. Br J Surg 71: 12 – 16PubMedGoogle Scholar
  98. 98.
    Phillips RKS, Hittinger R, Bleskovsky L et al. (1984) Local recurrence following “cura¬tive” surgery for large bowel cancer: II. The rectum and rectosigmoid. Br J Surg 71: 17 – 20PubMedGoogle Scholar
  99. 99.
    Pilipshen SJ, Heilweil M, Quan SHQ et al. (1984) Patterns of pelvic recurrence following definitive resections of rectal cancer. Cancer 53: 1354 – 1362PubMedGoogle Scholar
  100. 100.
    Pollett WG, Nicholls RJ (1982) The relationship between the extent of distal clearance and survival and local recurrence rates after curative anterior resection for adeno-carcinoma of the rectum. Ann Surg 198: 159 – 163Google Scholar
  101. 101.
    Quirke P, Dixon MF, Durdey P, Williams NS (1986) Local recurrence of rectal cancer due to inadequate surgical resection. Lancet 11: 996 – 999Google Scholar
  102. 102.
    Rao AR, Kagan AR, Chan PM, Gilbert HA, Nussbaum H, Hintz BL (1981) Patterns of recurrence following curative resection alone for adenocarcinoma of the rectum and sigmoid colon. Cancer 48: 1492 – 1495PubMedGoogle Scholar
  103. 103.
    Reid JD, Robins RE, Atkinson KG (1984) Pelvic recurrence after anterior resection and EEA stapling anastomosis for potentially curable carcinoma of the rectum. Am J Surg 147: 629 – 632PubMedGoogle Scholar
  104. 104.
    Reinbach DH, McGregor JR, Murray GD et al. (1994) Effect of the surgeon’s specialty interest on the type of resection performed for colorectal cancer. Dis Colon Rectum 37: 1020 – 1023PubMedGoogle Scholar
  105. 105.
    Rich T, Gunderson LL, Lew R et al. (1983) Patterns of recurrence of rectal cancer after potentially curative surgery. Cancer 52: 1317 – 1329PubMedGoogle Scholar
  106. 106.
    Sauer I, Bacon H (1951) Influence of lateral spread of cancer of the rectum on radicality of operation and prognosis. Am J Surg 81: 111 – 120PubMedGoogle Scholar
  107. 107.
    Scholefield HJ, Northover JMA (1995) Surgical management of rectal cancer (for debate). Br J Surg 82: 745 – 748PubMedGoogle Scholar
  108. 108.
    Stearns MW, Deddish MR (1959) Five-year results of abdominopelvic lymphnode dis-section for carcinoma of the rectum. Dis Colon Rectum 3: 169 – 172Google Scholar
  109. 109.
    Sugarbaker PH, Corlew S (1982) Influence of surgical techniques on survival in patients with colorectal carcinoma. Dis Colon Rectum 25: 545 – 557PubMedGoogle Scholar
  110. 110.
    Surtees P, Ritchie JK, Phillips RKS (1990) High versus low ligation of the inferior me-senteric artery in rectal cancer. Br J Surg 77: 618 – 621PubMedGoogle Scholar
  111. 111.
    Swiss Group for Clinical Cancer Research (SAKK) (1995) Long-term results of single course of adjuvant intraportal chemotherapy for colorectal cancer. Lancet 345: 349 – 353Google Scholar
  112. 112.
    Tornquist A, Ekelund J, Leandoer L (1982) The value of intensive follow-up after curative resection for colorectal carcinoma. Br J Surg 69: 725 – 728Google Scholar
  113. 113.
    Treurniet-Donker AD, Putten WLJ van, Wereldsma JCJ (1991) Postoperative radiation therapy for rectal cancer. Cancer 67: 2042 – 2048PubMedGoogle Scholar
  114. 114.
    Turnbull RB, Kyle K, Watson FR et al. (1967) Cancer of the colon; the influence of the no-touch technique on survival rates. Ann Surg 166: 420 – 427PubMedGoogle Scholar
  115. 115.
    Vogel P, Klosterhafen B (1988) Die chirurgische Anatomie der Rectum- und Analgefäβte. Langenb Arch Chir 373: 264 – 269Google Scholar
  116. 116.
    Wiggers T, Jeekel J, Arends JW et al. (1985) The no-touch isolation technique in colon cancer: a prospective controlled multicentre trial. Br J Surg 72 (Suppl):S 135Google Scholar
  117. 117.
    Williams NS (1993) Surgical treatment of rectal cancer. In: Keighly MRB, Williams NS (eds) Surgery of the anus, rectum and colon. Saunders, London, p 393Google Scholar
  118. 118.
    Williams NS, Johnston D (1984) Survival and recurrence after sphincter saving resection and abdominoperineal resection for carcinoma of the middle third of the rectum. Br J Surg 71: 278 – 282PubMedGoogle Scholar
  119. 119.
    Williams NS, Dixon MF, Johnston D (1983) Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: a study of distal intramural spread and of patients’ survival. Br J Surg 70: 150 – 154PubMedGoogle Scholar
  120. 120.
    Wolff BG (1992) Lateral margins of resection in adenocarcinoma of the rectum. World J Surg 16: 467 – 469PubMedGoogle Scholar
  121. 121.
    Zirngibl H, Husemann B, Hermanek P (1990) Intraoperative spillage of tumor cells in surgery for rectal cancer. Dis Colon Rectum 33: 610 – 614PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • Carlo W. Taat
  • C. Paul Maas
  • Willem-Hans Steup
  • Cornelis J. H. van de Velde

There are no affiliations available

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