Current use of sphincter-saving excision in the radical treatment of rectal cancer
Goligher, J.C.
Canadian Journal of Surgery. Journal Canadien de Chirurgie 28(5): 412-415
1985
ISSN/ISBN: 0008-428X PMID: 4027786 Document Number: 257494
The author examines the recent increased use of sphincter-saving forms of excision to treat carcinomas of the middle third and upper part of the lower third of the rectum. This trend has been due chiefly to technical innovations--especially the introduction of the circular stapler, which has extended the downward reach of low anterior resection--and the willingness to accept a distal margin of clearance in resections of 2.0 to 2.5 cm instead of 4 to 5 cm. Published data show that these innovations are associated with a low operative mortality and that satisfactory anorectal function can be retained. Insufficient length of follow-up, however, has made it impossible so far to calculate valid long-term survival rates and the high incidence of local recurrence in some reports has been disturbing.