In the field of surgery for cancer there is scarcely anything as discouraging as the specter of local recurrence after operation. Metastases to lymph nodes and other distant foci can be looked upon as "visitations" which are more or less beyond human control. The local reappearance of a tumor in the region of an operative site, on the other hand, possibly implies that certain sins of omission or commission were perpetrated.
In respect to operations for cancer of the rectum and sigmoid, local recurrences which follow the operation of combined abdominoperineal resection are diagnosed so late that little can be accomplished by reexaminations, as shown by Wangensteen and associates.41 In the case of anterior resection, by contrast, proper use of the proctoscope in the postoperative reexamination may disclose recurrent lesions while they are still removable.
But the aim of the surgeon is to prevent, rather than to treat, recurrences,
LOFGREN EP, WAUGH JM, DOCKERTY MB. Local Recurrence of Carcinoma After Anterior Resection of the Rectum and the Sigmoid: Relationship with the Length of Normal Mucosa Excised Distal to the Lesion. AMA Arch Surg. 1957;74(6):825–838. doi:10.1001/archsurg.1957.01280120003001
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