Local excision of rectum tumors - an alternative for extensive abdominal operations (LAR, APR)

Colorectal tumors present as a serious medical as well as social economic problem and remain a frequent of cause death. The study was performed on 359 patients with colorectal neoplasms. They were operated at the Colorectal and General Surgery of Medical University of Lodz and at the Department of Surgery of the Hospital of the Ministry of Internal Affairs and Administration in Lodz, Poland, between January 1st 1994 and December 31 2003. The analysis was performed on a group of 268 patients with rectal tumors identified within a distance 20 cm from the sphincterline. Complications after APR and LAR observed in the course of hospitalization (over 7 days) occurred in 19.9% of cases, however, after discharge they were observed in a some further 27.1% of patients, the accounting for a total of 52.6% cases. In case of LE we observed complication in 42.4% of cases; a majority of these were time-reversible. The period of hospitalization was significantly shorter after LE (6-3 days), a compared to 9.2 days after LAR and 9.8 days after APR. Local exicion of rectal tumours is an effective, radical and safe method of treatment of early tumours characterized as T1 and G1 and a low localization. When compared to LAR and APR LE in less traumatic and is associated with a lesser number of complications. It also requires shorter hospitalization and allows for an earlier return to intestinal nutrition. (author)