The indication of low anterior resection for lower rectal cancer.

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We report our results and indication of low anterior resection for lower rectal cancer. The cases were 35 of low anterior resection and 58 of abdominoperineal rectal resection. Factors considered included distance from the dentate line to the lower tumor edge, distance from the lower tumor edge to the resection line, tumor recurrence and prognosis.<BR>As a rule, we attempted to leave at least 2cm between the lower tumor edge and the resection line, but there were 4 cases in which less than 2cm were left ; even so, all cases tested negative for the presence of tumor cells at the resected edge. Local recurrence was seen in one case which had recieved low anterior resection and in 10 cases which had received abdominoperineal rectal resection. Five-year survival rates were 71% for the former group and 81% for the latter, no significant difference between the two groups.<BR>From these results, we conclude that low anterior resection is indicated in cases where at least 2cm may be left between the resection line and the lower tumor edge. Therefore, the required condition during preoperative examination is that the lower tumor edge must be at least 3.5cm from the dentate line.