NERVE-SPARING SURGERY WITH LATERAL NODE DISSECTION FOR ADVANCED LOWERRECTAL-CANCER

133 patients who underwent nerve-sparing surgery with lateral dissecti on for lower rectal cancer were analysed for survival and functional r esults, operative burdens, and modes of recurrence. In 84% of patients an acceptable urinary function was preserved. Operative time averaged 334 min, and blood loss averaged 935 mi. The 5-year survival rate was 67% in all patients, and 88% for Dukes' A, 74% for Dukes' B and 59% f or Dukes' C. According to the number of positive nodes, the 5-year sur vival rate comprised 83% of patients with up to three nodes, and 34% o f those with more than four nodes. Local recurrent rates were 2.7% in patients with Dukes' B and 13% with Dukes' C. At present, pelvic nerve -sparing procedures with lateral dissection is the most promising surg ery, guaranteeing both adequate lymphadenectomy and preservation of ur inary function.