2ND SURGERY WITH RECTAL EXERESIS FOR RECU RRENCE AFTER ANTERIOR RESECTION OF A RECTOSIGMOID CANCER

From June 1986 to December 1992, 16 patients (12 men and 4 women, 63 y ears-old [36 to 79]) who underwent a prior sphincter-saving resection for colorectal adenocarcinoma were operated on for locoregional recurr ence with a surgical resection. Eight patients had a second anterior r esection (5 colorectal, 2 coloanal and I ileoanal anastomosis), one a resection without anastomosis, and 7 an abdominoperineal resection. Ni ne patients received an intraoperative irradiation (10 to 25 Gy). Exci sions of surrouding organs were often necessary. Post-operative compli cations occured in most of the patients. Excluding 3 post-operative de aths, 9 patients died of disease in a median of 12,9 months after surg ery (range : 3 to 32 months). Four patients are still living 5 to 14 m onths after the second resection. There is little in the surgical lite rature dealing with these difficult surgical problem of which results are always uncertain. An earlier diagnosis of the recurrence would res ult in a more satisfactory procedure, but is difficult because of the limited possibilities of detection after surgical treatment and often external irradiation.