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. 1976 May;183(5):556–565. doi: 10.1097/00000658-197605000-00013

The curative treatment of carcinoma of the sigmoid, rectosigmoid, and rectum.

S M Wilson, O H Beahrs
PMCID: PMC1344346  PMID: 1275595

Abstract

This retrospective series comprises 902 patients who underwent curative resection of the sigmoid colon, rectosigmoid, and upper rectum at the Mayo Clinic during the years 1959 to 1969. Lesions were divided according to the location from the dentate line, with 346 patients having had a lesion located more than 20 cm from the dentate line; in the remaining 556 patients, the lesion was between 6 and 20 cm distant. A thorough analysis was undertaken comparing these two groups of patients on the basis of operative mortality and morbidity, including anastomotic complications, 5- and 10-year survival, and incidence of local recurrence. Overall operative mortality was 1.9%, with an 8.1% incidence of anastomotic complications. The overall 5-year survival rate was 72% and the 10-year survival rate was 55%. The incidence of anastomotic recurrence for anastomosis performed with the use of extraperitoneal rectum was 5.8%; recurrence at the suture line developed in 2.9% of patients who underwent anastomosis to serosa-covered bowel. In addition to the above data, information will be presented which demonstrates the effect of the patient's height and weight on the surgeon's ability to perform a low-anterior anastomosis. Finally, the incidence of anastomotic complications and of local recurrence were analyzed according to the intestinal preparation employed, the use of parenteral antibiotics , and the method of drainage used near the anastomosis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. GRINNELL R. S. Distal intramural spread of carcinoma of the rectum and rectosigmoid. Surg Gynecol Obstet. 1954 Oct;99(4):421–430. [PubMed] [Google Scholar]
  2. Goligher J. C., Graham N. G., De Dombal F. T. Anastomotic dehiscence after anterior resection of rectum and sigmoid. Br J Surg. 1970 Feb;57(2):109–118. doi: 10.1002/bjs.1800570208. [DOI] [PubMed] [Google Scholar]
  3. HALLENBECK G. A. Sphincter saving operations for carcinoma of the distal twenty centimeters of the rectum and colon. Gastroenterology. 1958 Feb;34(2):313–319. [PubMed] [Google Scholar]
  4. Labow S. B., Salvati E. P., Rubin R. J. Suture-line recurrence in carcinoma of the colon and rectum. Dis Colon Rectum. 1975 Mar;18(2):123–125. doi: 10.1007/BF02587157. [DOI] [PubMed] [Google Scholar]
  5. Morson B. C., Vaughan E. G., Bussey H. J. Pelvic Recurrence after Excision of Rectum for Carcinoma. Br Med J. 1963 Jul 6;2(5348):13–18. doi: 10.1136/bmj.2.5348.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Nichols R. L., Broido P., Condon R. E., Gorbach S. L., Nyhus L. M. Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery. Ann Surg. 1973 Oct;178(4):453–462. doi: 10.1097/00000658-197310000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Palumbo L. T., Sharpe W. S. Anterior versus abdominoperineal resection. Resection for rectal and rectosigmoid carcinoma. Am J Surg. 1968 May;115(5):657–660. doi: 10.1016/0002-9610(68)90095-0. [DOI] [PubMed] [Google Scholar]
  8. Peloquin A. B. Factors influencing survival with complete obstruction and free perforation of colorectal cancers. Dis Colon Rectum. 1975 Jan-Feb;18(1):11–21. doi: 10.1007/BF02587232. [DOI] [PubMed] [Google Scholar]
  9. QUER E. A., DAHLIN D. C., MAYO C. W. Retrograde intramural spread of carcinoma of the rectum and rectosigmoid; a microscopic study. Surg Gynecol Obstet. 1953 Jan;96(1):24–30. [PubMed] [Google Scholar]
  10. Slanetz C. A., Jr, Herter F. P., Grinnell R. S. Anterior resection versus abdominoperineal resection for cancer of the rectum and rectosigmoid. An analysis of 524 cases. Am J Surg. 1972 Jan;123(1):110–117. doi: 10.1016/0002-9610(72)90318-2. [DOI] [PubMed] [Google Scholar]
  11. VANDERTOLL D. J., BEAHRS O. H. CARCINOMA OF RECTUM AND LOW SIGMOID; EVALUATION OF ANTERIOR RESECTION OF 1,766 FAVORABLE LESIONS. Arch Surg. 1965 May;90:793–798. doi: 10.1001/archsurg.1965.01320110129021. [DOI] [PubMed] [Google Scholar]
  12. WAUGH J. M., BLOCK M. A., GAGE R. P. Three and five-year survivals following combined abdominoperineal resection, abdominoperineal resection with sphincter preservation, and anterior resection for carcinoma of the rectum and lower part of the sigmoid colon. Ann Surg. 1955 Oct;142(4):752–757. doi: 10.1097/00000658-195510000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Washington J. A., 2nd, Dearing W. H., Judd E. S., Elveback L. R. Effect of preoperative antibiotic regimen on development of infection after intestinal surgery: Prospective, randomized, double-blind study. Ann Surg. 1974 Oct;180(4):567–572. doi: 10.1097/00000658-197410000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]

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