Rectal cancer surgery in a district general hospital: controlled follow-up study.

Local recurrence after curative surgery of rectal cancer indicates failure of the initial treatment. In recent years reported local recurrence rates have steadily decreased. In this study 364 patients treated for rectal cancer were analyzed retrospectively to determine if it is still justified to treat this disease in small nonspecialized hospitals. An overall local recurrence rate of 9.7% was found for all operation methods used. Local recurrence rates were 11.6% for patients treated by low anterior resection, 8.4% for the patients who sustained an amputation of the rectum, and 7.1% for the patients treated by transanal tumor resection. None of the patients in whom we performed a total mesorectal excision has developed local recurrent disease during the observation period. Careful surgical technique and close follow-up of the patients being prerequisites, the results of this study justify continuing to treat rectal cancer in nonspecialized centers.