[The role of local excision in the surgical treatment of rectal cancer].

Unlabelled: Between 1984 and 1992 authors performed 307 surgical interventions for patients with rectal cancer, of these 199 operations were curative (65%). Local excision of the tumour was carried out in 9 cases: 2 with palliative intent, 7 were considered a curative treatment, that constituted 3.5% of all curative procedures. Five tumours were removed by transanal local excision, 2 located in the upper part of the rectum required laparotomy and rectotomy. No operative mortality. One wound sepsis was registered after laparotomy. There was one local recurrence after removing the primary tumour. At the same time 83 patients suffering abdominoperineal resection or anterior resection had tumour limited to the rectal wall without lymph node metastasis. The mortality was 1.4%, the morbidity 28% and local recurrence rate was 19% in this group. The difference between the the results of the two groups did not achieve statistical significance included the survival too. Of the 83 tumours removed by more radical operations 38 located between 1-8 cm from the anal verge. Excluding tumours poorly differentiated and those with diameter larger than 3 cm, 17 rectal cancer would have been suitable for transanal local excision, that constitutes 8.5% of the curative operations.

Conclusion: with more accurate preoperative staging the transanal local excision for carcinoma of the rectum can be performed more frequently than earlier. The risk of the operation is lower than those of the abdominoperineal or anterior resection and the late results are comparable if strict selection criteria are implemented.