[Prediction of local recurrences after surgery of carcinoma of the middle reticulum (author's transl)].

On the basis of completely and exactly documented follow-up data of 237 patients on whom carcinomas of the middle rectum were resected for cure, a multivariate statistical model was developed and the corresponding parameters were calculated. With this model the individual risk of local recurrences can be estimated after anterior resection with a small margin of clearance (11-30 mm on the fresh specimen without stretching), after anterior resection with a wide margin of clearance (more than 30 mm), and after excision of the rectum. Seven prognostic factors are taken into consideration that can be determined pre- and intraoperatively. Estimations of the risk of local recurrences on the basis of observed and documented follow-up data can be used as decisive factor for differential indication between restorative and excisional surgery on future patients. After anterior resection the risk of local recurrences is calculated according to macroscopic findings on the specimen and to frozen section histology. If the risks in anterior resection and excision are approximately equal, the resection is ended by anastomosis; otherwise the operation will be extended to excision of the rectum. This statistical model enables the surgeon to select the proper operative procedure for each individual situation (histology- and stage-adapted surgery).