[Diagnosis and surgical treatment of recurrences of rectal cancer].

The authors present the analysis of the results of surgical treatment of 145 patients with recurrent rectal carcinoma in 1960-1990 at the State Scientific Centre of Proctology. A group of 304 patients who underwent radical operation for carcinoma of the rectum was also studied to determine the frequency of recurrences after radical surgery. It was found to be 30.9% (in 94 out of 304 patients). More than half of carcinoma recurrences (63.8%) were revealed in the first postoperative year and 85.1% in the first two years. The average term of their appearance was 13.4 months. A radical operation may be performed for a second time in only 22.3% of cases of recurrences. The study of factors considerably influencing the frequency of the recurrence made it possible to determine three groups of patients with various risks of the development and create a scheme of their regular medical examination. Repeated radical operations on the cavities were carried out in 90 patients with recurrences, in 55 patients local resection of recurrrent tumor was performed. The indications for repeated operations were elaborated. More than half repeated operations on the cavity (53.3%) were combined, extensive, and concomitant. The incidence of intraoperative (52.2%) and postoperative (62.2%) complications was significantly higher than in primary operations. The use of a complex of therapeutic and preventive measures usulted in relatively low postoperative lethality (6.7%). Five-year survival after repeated operations on the cavity was 29 +/- 5.5%, the frequency of repeated recurrences was 34.5 +/- 5.2%; the respective figures after local excision were 14.6 +/- 5.5 and 40.8 +/- 7%.