Pelvic recurrence rate after abdominoperineal resection and low anterior resection for rectal cancer before and after introduction of the stapling technique.

Pelvic recurrence rates after abdominoperineal resection (APR) and low anterior resection with the EEA stapler (LAR) for rectal cancer were compared. Since a controlled trial is not possible, we have compared the pelvic recurrence rate over a 2-year period before and after introduction of the EEA stapler. Before introduction of the stapler, standard treatment for midrectal tumors was APR while LAR has been the standard treatment of these cancers after introduction of the EEA stapler. A total of 164 patients underwent surgery for rectal cancer in this 4-year period, 85 in the first 2-year period and 79 in the last 2-year period. No difference could be demonstrated in pelvic recurrence rate after APR and LAR in the 2 periods [22.7% (95% confidence limits: 10.1–39.1%) and 22.2% (11.5–37.8%), respectively]. The recurrence rate was highest among Dukes' C tumors, but was unrelated to the type of operation.