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Surgery of rectal cancer (technical observations).

The evolution of the surgical management of rectal cancer is briefly reviewed. Factors which influence the choice of the surgical procedure relatively to the tumor characteristics, are examined. The role played by preoperative staging as the basis of a correct therapeutic approach is underlined. Most common surgical procedures in rectal cancer treatment are reported, and emphasis is put on aspects of particular interest for radiodiagnosticians and radiotherapists.

Humans↗

PubMedDate not supplied

Rectal exploration in rectal cancer. Double contrast enema vs rectoscopy: a comparison of present diagnostic accuracy.

The present role of rectal exploration in rectal cancer is defined. Indications and limitations of endoscopy and radiology in the study of colon relatively to the diagnosis and pre-treatment approach to rectal cancer, are reviewed. The need to establish definite parameters of tumor morphology indispensable to a correct surgical management, to a possible neoadjuvant therapy and to a precise assessment of the response to therapy, is emphasized. Compared results about the lengthwise tumor extent, the circumferential involvement of rectal walls and the distance from the internal anal sphincter, are reported. It is concluded that the two diagnostic examinations are complementary and that both represent excellent methods for the diagnosis and assessment of the extent of the disease.

Barium Sulfate↗

PubMedDate not supplied

[Prognostic factors in local-regional recurrences of colorectal neoplasms].

PURPOSE: The aim of this study was to evaluate, in a group of patients suffering of colo-rectal cancer, the influence on local recurrence of some clinical and anatomo-pathological variables. METHODS: The study was limited to 833 patients who underwent potentially curative resection and have been followed for at least two years. All patients were evaluated every six months for the first three years and yearly thereafter by means of clinical, laboratory, endoscopic and radiological investigations. Recurrence was observed in 78 patients (9.4%); 19 of these had evidence of distal failure simultaneously (2.2%). The incidence was 2.4% and 17.7% in the carcinoma of the colon and rectum respectively. Median time of recurrence was 16 +/- 11 months; 75% presents within 23 months from operation. Chi-square test was used to relate incidence of recurrence to clinical and anatomo-pathological factors and then a multivariate logistic regression analysis was used to evaluate the most significant variables. RESULTS: Univariate analysis reveals a significant relationship between recurrence and age under 50 years (p = 0.01), presence of preoperative complication (p = 0.01), stage (p = 0.01), site (p = 0.000) of primary tumor and lymph-nodal involvement (p = 0.0002). No statistically significant difference was found between recurrence and tumor wall infiltration, number of lymph nodes involved, grading and morphology of primary tumor. Multivariate logistic regression analysis confirmed these results except for preoperative complication (p = 0.9). CONCLUSIONS: Authors believe that selection of patients to undergo adjuvant therapies is improved by identification of high-risk patients.

Age Factors↗