Local recurrence after sphincter-saving resection for rectal and rectosigmoid carcinoma. Value of various diagnostic methods.

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Abstract
Cases (51) [human] of local recurrence after sphincter-saving resection for rectal and rectosigmoid carcinoma to assess the sensitivity of current diagnostic procedures. A combination of follow-up serum CEA [cinoembryonic antigen] levels and rectoscopy was found to be most efficient during the 1st 2 yr after surgery in terms of the time, frequency and location of the recurrence as well as the cost-benefit ratio. On the other hand, almost all recurrent lesions developed extraluminally, infiltrating the suture line secondarily; moreover, 25% extended outside the bowel wall. Thus in addition to endoscopy, CT [computed tomography] is useful as a means of defining the entire mass at the anastomosis as well as detecting periocolic recurrence and is essential if repeat resection is contemplated.