Prognostic assessment after local resection for the treatment of small carcinoma in lower rectum.

Local resection of the lower rectum was performed for the treatment of malignant polypoid lesions in 22 patients. The clinical outcomes of the procedure are summarized as follows; 1. For IIa + IIc type malignant polyp, transanal wedge resection of the entire rectal wall or a transsacral tube resection of the rectum should be performed; as a minimal preventive measure against local recurrence. 2. Early invasive carcinoma (sm) has a metastatic potential on distant organs. 3. In the case of polypoid carcinoma invading the muscle layer (pm), local resection was conducted only in the patients with distant metastasis or with serious complications and in aged patients. 4. When postoperative histological examination reveals a mistake in operative strategy, the patient should be reoperated immediately.