WIDE RESECTION AND RECONSTRUCTION PRESERVING FECAL CONTINENCE IN RECURRENT ANAL CANCER - REPORT OF 3 CASES

PURPOSE: A new operation was developed to treat patients with local re currence of cancer at the anal margin after radiotherapy. This operati on aims at resection of the tumor with oncologically safe margins, pre servation of fecal continence, and reliable wound healing. METHODS: Af ter intensive radiotherapy, three patients with local recurrences of s quamous-cell carcinoma of the anus refused to undergo abdominoperineal resection. These patients were treated by wide local excision and pri mary reconstruction. Wide local excision included perianal skin with s ubcutis and the anal canal including the internal sphincter up to the dentate line. To reconstruct the anus, the rectum was mobilized and br ought down to the level of the perineum through the external sphincter and anastomosed to bilateral biceps femoris myocutaneous flaps. RESUL TS: In the first three patients no tumor recurrences have occurred, an d fecal continence has been good. CONCLUSION: The first results with t his continence-preserving operation in patients with recurrent anal ma rgin cancers after radiotherapy have been encouraging.