[Abdomino-perineal rectum amputation for therapy of locoregional recurrence after anterior resection].

In a retrospective study (1979-1988) we evaluated the outcome of the abdominoperineal amputations of the rectum in 9 patients for local recurrence after anterior resection. The technical feasibility of the secondary rectum amputation, early and late results and indications for the operation are discussed. The secondary rectum amputation for local recurrence after primary anterior resection is a difficult operation. A low morbidity and a zero mortality are reported. Late results are bad; 8 of 9 reoperated patients are deceased 22 (6-60) months and 1 patient is alive 32 months after the rectum amputation. The only indication for reoperation is an operation with curative intention. The early recognition of a local recurrence is of up-most importance. It is reported that with endorectal ultrasound it is possible to pick up small and asymptomatic local recurrences. Perhaps the recognition of a small local recurrence with endoluminal sonography enables to ameliorate the late results of this rare intervention.