Objectives: To evaluate the effect and the indication of local resection for rectal cancer below the peritoneal reflection.
Methods: One hundred and thirty-four patients with early rectal carcinoma whose masses were >or= 5 cm or
Results: No recurrence appeared in 47 patients with intra-mucosal carcinoma (M-Ca). In 87 patients with submucosal carcinoma (SM-Ca), 3 patients were positive for the cutting end, 8 showed vessel infiltration, and 5 showed low-differentiated adenocarcinoma. These patients had to accept mile's operation, but one patient had local recurrence and 2 patients had liver metastases. Two patients had local recurrence and 8 had metastasis of the liver and other sites. The total 5-year survival rate was 94%.
Conclusions: Trans-sacral local resection is an optimal operation since the operative range is small and artificial anus is avoided. However, it is only suitable for early rectal carcinoma. When vessel infiltration or low differentiation or positive cutting end are confirmed, radical operation should be added.
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