Local excision of rectal tumours

✍ Scribed by F. Smedley; D. A. Macfarlane; C. V. Mann

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 129 KB
• Volume: 73
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800730424

✦ Synopsis

S57-8)

, in which the importance of patient selection is stressed. It is stated that only tumours of favourable cytological differentiation ('well' or 'average' histological grade) are suitable for these local radical techniques.

It is important to draw attention to the fact that it is not possible to exclude accurately all poorly differentiated tumours pre-operatively based on the results of rectal biopsies. In a recent study' we found that 70 per cent of poorly differentiated growths had been thought to be of only average grade when the rectal biopsy was examined. These findings were confirmed by Elliott et a/.' who found that only 17 of 42 poorly differentiated tumours were correctly identified as being of unfavourable histological grade on rectal biopsy, a 60 per cent error.

The discovery of unfavourable histology after local excision may result in a medically unfit patient being subjected to further surgery. lnaccuracy in the histological grading of rectal biopsies means that it cannot be certain that selection is completely correct when advocating local excision.