Skip to main content
Log in

Anastomotic recurrence after sphincter-saving resection for rectal cancer

Length of distal clearance of the bowel

  • Published:
Diseases of the Colon & Rectum

Abstract

A retrospective study of anastomotic recurrence after sphincter-saving resection for rectal cancer is presented. During the 21 years from 1962 to 1982, 273 patients with rectal cancer underwent sphincter-saving resection and 30 (11 percent) of them had anastomotic recurrences. Computer analysis of 69 variables was undertaken to identify factors contributing to the anastomotic recurrence, with special reference to the length of distal clearance of the bowel. There was no significant correlation between the incidence of recurrence and the length of distal clearance of the bowel, if the latter was over 2 cm. There appears to be justification for carrying out a curative sphincter-saving operation for cases in which more than a 2-cm distal margin can be afforded. However, for cancers of the infiltrating type, annular growths, invasion to adjacent organs or mucinous features, a more extensive distal clearance of the bowel is necessary, and the Miles operation should be performed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Black WA, Waugh JM. The intramural extension of carcinoma of the descending colon, sigmoid, and rectosigmoid. Surg Gynecol Obstet 1948;87:457–64.

    PubMed  CAS  Google Scholar 

  2. Quer EA, Dahlin DC, Mayo CW. Retrograde intramural spread of carcinoma of the rectum and rectosigmoid: a microscopic study. Surg Gynecol Obstet 1953:96:24–30.

    PubMed  CAS  Google Scholar 

  3. Hojo K, Kodaira S, Koyama Y. Criteria of choice for sphincter saving procedures for rectal cancer. Operation (Jap) 1976; 30:1093–8.

    Google Scholar 

  4. Grinnell RS. Distal intramural spread of carcinoma of the rectum and rectosigmoid, Surg Gynecol Obstet 1954;99:421–30.

    PubMed  CAS  Google Scholar 

  5. Goligher JC, Dukes CE, Bussey HJ. Local recurrences after sphincter-saving excisions for carcinoma of the rectum and rectosigmoid. Br J Surg 1951;39:199–211.

    Article  PubMed  CAS  Google Scholar 

  6. Hojo K, Koyama Y, Ito I. Recurrence of large bowel cancer and its countermeasures. Surgery (Jap) 1972;34:1025–35.

    Google Scholar 

  7. Deddish MR, Stearns MW Jr. Anterior resection for carcinoma of the rectum and rectosigmoid area. Ann Surg 1961;154:961–6.

    PubMed  CAS  Google Scholar 

  8. Cullen PK Jr, Mayo CW. A further evaluation of the one-stage low-anterior resection. Dis Colon Rectum 1963;6:415–21.

    Article  PubMed  Google Scholar 

  9. Morgan CN. Carcinoma of the rectum. Ann R Coll Surg Engl 1965;36:73–97.

    PubMed  CAS  Google Scholar 

  10. Hojo K. Sphincter saving procedure for rectal cancer. Tokyo: Health Publication Company, 1982.

    Google Scholar 

  11. Goligher JC. Current trends in the use of sphincter-saving excision in the treatment of carcinoma of the rectum. Cancer 1982; 50:2627–30.

    PubMed  CAS  Google Scholar 

  12. Slanetz CA Jr, Herter FP, Grinnell RS. Anterior resection versus abdominoperineal resection for cancer of the rectum and rectosigmoid. Am J Surg 1972;123:110–7.

    Article  PubMed  Google Scholar 

  13. Pollett WG, Nicholls RJ. The relationship between the extent of distal clearance and survival and local recurrence rates after curative anterior resection for carcinoma of the rectum. Ann Surg 1983;198:159–63.

    Article  PubMed  CAS  Google Scholar 

  14. Phillips RK, Hittinger R, Blesovsky L, Fry JS, Fielding LP. Local recurrence following “curative” surgery for large bowel cancer. Br J Surg 1984;71:17–20.

    Article  PubMed  CAS  Google Scholar 

  15. Labow SB, Salvati EP, Rubin RJ. Suture-line recurrence in carcinoma of the colon and rectum. Dis Colon Rectum 1975;18:123–5.

    Article  PubMed  CAS  Google Scholar 

  16. Grinnell RS. Lymphatic block with atypical and retrograde lymphatic metastasis and spread in carcinoma of the colon and rectum. Ann Surg 1966;163:272–80.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Hojo, K. Anastomotic recurrence after sphincter-saving resection for rectal cancer. Dis Colon Rectum 29, 11–14 (1986). https://doi.org/10.1007/BF02555276

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02555276

Key words

Navigation