2. Anastomotic Recurrence after Sphincter-Preserving Procedures for Carcinoma of the Rectum and Rectosigmoid

概要

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During the period 1962 to 1974, 63 sphincter preserving procedures for rectal cancer were performed at NCC Hospital. Post-operative prognosis and the realities of recurrence (mainly anastomotic recurrence) after these procedures were studied. The survival rate after sphincter preserving procedures was considerably higher than for abdomino-perineal resections. The crude five-year survival rate for the sphincter-preserving procedure was 78.4%, as compared to 47.1% for combined abdomino-perineal resection. Recurrence of carcinoma at the site of anastomosis was found in 9 of 63 cases, an incidence of 14.3 %. Incidence of anastomotic recurrence was increased with resection of more distal lesions. Lymphnode involvement had no relationship to recurrence at the anastomosis. The relationship between length of free margin distal to the tumor and several pathological characteristics (macroscopical type, size of tumor and depth of invasion) of the primary tumor with regard to anastomotic recurrence was also investigated. The result indicates that, if the size of tumor is more than 3cm and the tumor infiltrate to muscle coat, a margin of 4.1cm or more of uninvolved bowel below the tumor offer significant protection from recurrence. We further refered to the indication of this procedure and the treatment of anastomotic recurrent cases.
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