Comparison of the mortality, morbidity and incidence of local recurrence in patients with rectal cancer treated by either stapled anterior resection or abdominoperineal resection.

One hundred patients with rectal cancer treated by one surgeon over a 7 year period are reviewed. Fifty-five patients were treated by stapled anterior resection (SAR) and 45 by abdominoperineal resection (APR). Dukes' classification, degree of differentiation and local spread were similar in both groups. Operative mortality was 7.2 per cent for SAR and 2.2 per cent for APR. Anastomotic leakage following SAR occurred clinically in two patients (3.6 per cent), one of which proved fatal, and radiologically in five patients. Morbidity after SAR and APR was otherwise similar. There was no significant difference in local recurrence rates after SAR (14.7 per cent) and APR groups (25.0 per cent). The results of this study suggest that for patients with rectal cancer radical excision with sphincter presentation using the circular stapler has a mortality, morbidity and risk of local recurrence comparable with radical excision with a permanent colostomy.