[Results of surgical therapy of rectal cancer at a regional hospital].

The results of surgical treatment of 198 unselected consecutive cases of adenocarcinoma of the rectum at a district hospital between January 1, 1977 and June 30, 1985 are analysed. Characteristics of patients at a primary referral center include old age (47.2% greater than or equal to 70 years) and advanced tumor stage (44.4% Dukes C and D). Despite these unfavourable cohort characteristics tumor excision rate was 97.5%, the proportion of sphincter saving resections 72.0%, using exclusively a single layer hand-sutured technique. Operative mortality was 3.6 and 5.5% for sphincter saving resection and abdomino-perineal excision respectively. The uncorrected cumulative probability of survival at five years is 56.1% for women, 35.0% for men, with a definite advantage for sphincter saving resection in both sexes. Uncorrected cumulative probability of survival according to tumor stage was 72.4% for Dukes stages A and B combined, 30.0% for Dukes C and 0 for D. Where oncologically radical rectal and mesorectal excision is possible from the sole abdominal access, there, hand-sutured abdominal anastomosis is also feasible and advantageous due to resorbable suture material. Taking into account the adversities of unselected patient cohorts, progress is still being achieved in rectal carcinoma surgery without "specialisation" but with improving general surgical and anaesthesiologic techniques.