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January 1989

Prospective Phase I Trial of Conservative Management of Low Rectal Lesions

Author Affiliations

From the Division of Surgery, Department of General Surgery (Drs McCready, Ota, and Jessup and Ms Thielvoldt) and Department of Clinical Radiotherapy (Dr Rich), University of Texas M. D. Anderson Cancer Center, Houston.

Arch Surg. 1989;124(1):67-70. doi:10.1001/archsurg.1989.01410010077016

• The purpose of this study was to assess anal function and to compare the morbidity of local excision and postoperative radiotherapy for rectal adenocarcinoma with the morbidity of abdominoperineal resection. A posterior parasacral approach was used for local excision. All patients had negative margins, and all but one were continent after completion of radiotherapy. Seven patients (29%) had either a wound infection or a fistula in the local excision group. No local failures occurred, although follow-up was only 13 months. Thirteen (50%) of the 26 patients who underwent an abdominoperineal resection developed at least one complication. Combined treatment that spares the rectal sphincters may be preferable in selected patients with low rectal cancer, if long-term disease-free survival is maintained.

(Arch Surg 1989;124:67-70)