A pilot study of sphincter-sparing management of adenocarcinoma of the rectum
G. Steele Jr, P. Busse, M. S. Huberman, J. M. LeClair, Z. M. Falchuk, R. J. Mayer, A. Bothe Jr, T. S. Ravikumar, M. Stone and J. M. Jessup
Department of Surgery, New England Deaconess Hospital, Harvard Medical School, Boston, MA 02215.
After analysis of 26 prospectively accrued patients with distal rectal
adenocarcinomas who underwent sphincter preservation treatment, we have
concluded that tumors that invade only the submucosa can safely be treated
with surgery alone and that tumors that invade the muscularis or further
can be safely treated with surgery combined with chemoradiotherapy. None of
the patients had either local or distant recurrence, with a median
follow-up of 21 months. All patients have been fully continent. The
results, although preliminary, imply that resection of distal rectal
adenocarcinoma with sphincter preservation, and adjuvant therapy when
appropriate, have achieved local and distant control equal to the
conventional Miles' abdominoperineal resection, but without the need for a
permanent colostomy.
