Premium
Extensive En bloc resection of regionally recurrent carcinoma of the rectum
Author(s) -
Maetani Shunzo,
Nishikawa Toshikuni,
Lijima Yasuyuki,
Tobe Takayoshi,
Kofoura Yoshihiko,
Shikata Jitsuhiko,
Yamamura Takao
Publication year - 1992
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19920615)69:12<2876::aid-cncr2820691203>3.0.co;2-q
Subject(s) - medicine , rectum , carcinoma , resection , general surgery , surgery
To remove regionally recurrent cancer of the rectum completely, more radical extensive resections were attempted than the conventional ones in 35 patients. Twenty‐two patients underwent total pelvic exentera‐tion. In 23, sacral resection was done, combined with other procedures including excision of the entire circumference of the lower pelvic ring. There were two hospital deaths. Delayed wound healing was seen in ten. Preoperative severe pain was alleviated in 18. Also, perineal ulcer, vaginal bleeding, bloody stools, and tenesmus disappeared. Of the four 5‐year survivors (estimated rate, 23%), only one was disease‐free. A second recurrence was seen in 27 patients, of whom 23 had regional failure. It was concluded that so‐called local recurrence is a lesion more widespread than indicated by imaging and biopsy. Therefore, even the most radical resection rarely can cure this disease. However, such a surgical procedure can afford more effective palliation than other treatments and may prolong life in selected patients significantly.