Özet:

Background: Although rectal cancers have a slowly progressive and these cancers are asymptomatic for a long time, it can be said that they are fatal systemic disease. Today, its primary treatment is surgery. Early diagnosis, correct preoperative staging, synchronicity and determining metachronous colorectal cancers and determining local recurrences in a treatable condition are the most important determines of the success of surgical treatment. In our study, by reviewing the characteristics of rectal cancers and the principles of surgical approach in the light of the current literature, we tried to examine rectal cancer cases detected and treated in our clinic in terms of etio-pathogenesis, pathology, symptomatology, diagnosis, treatment and recurrence results in the light of current literature. Materials and Methods: Between December 1993 and December 1999, we analyzed 82 patients who are operated on for rectal cancer in 2nd. General Surgery Clinic of Ministry of Health Ankara Training and Research Hospital. In this study, from archive files, patients’ age, gender, symptom, symptom duration, examinations, anatomical location of tumor, complications, tumor stage, postoperative adjuvant treatment, patient follow-up and local recurrences and distant metastases during this period were recorded. Results: The average age of our patients was 57.7, and 20% were under 40 years old. 30 (36,6%) of patients were female, 52 of the patients (63,4%) were male. 10 (12,1%) of the patients were operated urgently with acute abdominal pain and 72 (87,8%) of the patients were operated electively. Anemia was detected in 18.2% of the patients (Hemoglobin levels below 10 g / dl) in the complete blood cell counts. 11 (13,4%) of our cases had liver metastasis. CEA, CA19-9 levels during the diagnosis of 82 patients’ who had rectal cancer were examined. CEA level was found high in 60 (73,1%) patients, CA19-9 levels were found high in 35 (42,6%) patients. In the statistical analysis, CEA sensitivity was identified to be superior to CA19-9. Respectability ratio of our cases was 79,2%. According to the Modified Dukes classification, one patient (1.2%) in A stage, 8 patients (9.7%) in stage B1,17 patients (20.7%) in B2 stage, 19 patients (23.1%) in stage C1, 26 patients (31.7%) C2 and 11 patients (13.4%) in D stage were detected. Conclusion: In rectal cancers, early diagnosis, correct preoperative staging, synchronicity and determining metachronous colorectal cancers and determining local recurrences in a treatable condition are the most important indicatives of the success of surgical treatment. In addition, doctor – patient relationship to reach ideal conditions and ensuring the early diagnosis are essential to get successful results in this disease. Key words: Rectal cancer, Total mesorectal excision, Low anterior resection, Abdominoperineal resection