Clinicopathological study on local recurrence after Miles' operation.

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A total of 17 cases of local recuccence after Miles' operation for rectal cancer during past 4 years in our department were studied clinicopathologically. 4 of 17 cases were resect-able (operable group), and the remaining 13 cases were inoperable (inoperable group). The following factors were found to be predictive of local recurrence ; 1) the primary site of the tumor in the lower rectum, 2) the maximum diameter of the tumor over 5cm, 3) depth of invasion over a2, 4) ew under 2cm. The mean duration between the time of recurrence and the initial operation was 32.9±24.2 months. Perianal pain was the most frequent symptom and MRI had an important diagnostic value in detecting local recurrence. In operable group, most cases displayed late recurrence (tumor recurred after two years resection of the primary lesion), and all recurrent lesions measured less than 6cm in its maximum diameter presenting mild symptoms as well as low level of CEA. Comparative study on the risk factors of recurrence revealed that 2 of 8 cases were operable even though ew-factor (under 2cm), however all of 4 cases in which n-factor indicate high possibility of recurrence were inoperable. Causes of inoperability in recurrent tumors were as follows ; 1) invasion beyond the first sacrum 2) lateral invasion in the pelvic cavity. Resected cases showed good prognosis although they experienced serious complications after operation. On the contrary, inoperable cases died within two years after recurrence with poor quality of life.
日本大腸肛門病学会の論文

Clinicopathological study on local recurrence after Miles' operation.

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