RESEZIONE ANTERIORE NEI CARCINOMI DEL TERZO INFERIORE DEL RETTO

Evidence that the resection of the rectum 2 cm from the neoplasm is enough for oncological purpose and stapled anastomosis enormously increased the conservative surgery of the lower rectum. Thirteen patients with lower rectal cancer (5 to cm 8 from the anal verge) received anterior resection in the period 1980-1990. Intraoperative mortality was 7.7% (1 died for myocardial infarction). We observed 5 early complications (38.4%): 4 incomplete anastomotic leakages (2 treated by temporary colostomy and 2 by local therapy; any definitive colostomy was not necessary) and 1 neuropathic bladder successfully treated by medical therapy. Late complications consisted of 1 anastomotic stenosis (endoscopic treatment) and 3 local recurrences treated again with radical purposes (2 Miles abdominoperineal resections and 1 endoscopic laser therapy). In our opinion anterior resection is the best surgical treatment even for low rectal cancer; it provides a radical therapy, the rate of complications is quite low and an easy correction is possible; finally endoscopy and endosonography permit an early discovering of local recurrences and a radical therapy of them.