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A Journal on Surgery

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Chirurgia 1999 June;12(3):187-90

language: Italian

Pelvic recurrence after Miles operation for rectal cancer: postoperative evaluation

Vuolo G., Volterrani L., Collini A., Di Cosmo L., Capezzuoli A., Vegni V., Ricci V., Bellezza A., Pecci A. P., Carli A.


Early detection of rectal cancer local recurrence after abdomino-perineal resection allows surgical revision of the perineum in 5-10% of patients, which in association with radiotherapy, makes it possible to obtain good results of quality of life and survival. In 110 patients (majority B1 and B2 stage) postoperative CT-scans with CT guided biopsy were performed in doubtful cases. Twenty-four local recurrences (21.81%) were observed, among which 14 diagnosed only by CT scan (and confirmed by biopsy). In 10 cases CT scan was performed when there was already a clinical diagnosis of recurrence. In 6 patients it was possible to perform a surgical revision of perineal space with radiotherapy (25%), in 10 cases only radiotherapy (41.66%) and in 8 cases only a palliative treatment (33.33%). Compared to MRI, CT-scan gives the advantage of being more accessible, due to the larger number of scanners and being a less expensive examination. The conclusion is drawn that recurrent pelvic CT scan with frequent follow-up is the best method for early detection of rectal cancer pelvic recurrences.

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