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J R Soc Med. 1988 March; 81(3): 143–145.
PMCID: PMC1291506

Place of abdominoperineal excision in rectal cancer.


In an attempt to elucidate if and when there is a place for abdominoperineal excision in rectal cancer, we have evaluated survival, risk of local recurrence and functional results of alternative procedures. There seems to be no difference in survival rate after intended curative surgery for rectal cancer between rectal excision and sphincter-saving resection. This is also true with respect to risk of local recurrence, except in patients with poorly differentiated Dukes' C tumours, where the risk of significant distal intramural spread is increased. Functional results are satisfactory after low anterior resection with colorectal anastomosis, whereas colo-anal anastomosis is followed by less satisfactory results especially in elderly patients. In these patients rectal excision with a permanent colostomy is probably preferable.

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Selected References

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  • Luke M, Kirkegaard P, Lendorf A, Christiansen J. Pelvic recurrence rate after abdominoperineal resection and low anterior resection for rectal cancer before and after introduction of the stapling technique. World J Surg. 1983 Sep;7(5):616–619. [PubMed]
  • Madsen PM, Christiansen J. Distal intramural spread of rectal carcinomas. Dis Colon Rectum. 1986 Apr;29(4):279–282. [PubMed]
  • Pedersen IK, Christiansen J, Hint K, Jensen P, Olsen J, Mortensen PE. Anorectal function after low anterior resection for carcinoma. Ann Surg. 1986 Aug;204(2):133–135. [PubMed]
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  • Wilson SM, Beahrs OH. The curative treatment of carcinoma of the sigmoid, rectosigmoid, and rectum. Ann Surg. 1976 May;183(5):556–565. [PubMed]
  • Lane RH, Parks AG. Function of the anal sphincters following colo-anal anastomosis. Br J Surg. 1977 Aug;64(8):596–599. [PubMed]
  • Rudd WW. The transanal anastomosis: a sphincter-saving operation with improved continence. Dis Colon Rectum. 1979 Mar;22(2):102–105. [PubMed]
  • Keighley MR, Matheson D. Functional results of rectal excision and endo-anal anastomosis. Br J Surg. 1980 Oct;67(10):757–761. [PubMed]
  • Lazorthes F, Fages P, Chiotasso P, Lemozy J, Bloom E. Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum. Br J Surg. 1986 Feb;73(2):136–138. [PubMed]

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