The main problem of transanal excision for early rectal cancer in the present study was the inability to remove all the malignancy. Patients treated with transanal excision had significantly higher rates of local recurrence compared with patients who underwent major surgery. Patients who had transanal excision had inferior survival, but they were older than those who had major surgery.

No abstract

We found an independent and significant association between perioperative blood transfusion and poor prognosis in colorectal cancer patients. Blood storage time was not a prognostic factor.

41/472 patients (9%) developed small bowel obstruction after the primary operation for colorectal cancer. The aetiology was benign in 21 and malignant in 20 patients. Survival after operation for the obstruction was far better with benign than with malignant obstruction.

Two hundred sixty one patients with adenocarcinoma of the colon and rectum were studied with respect to histopathologic and macroscopic tumor characteristics. Nonmetastatic disease was associated significantly with well-differentiated tumors, tumors with pronounced inflammation, and polypoid adenocarcinomas. There was a higher proportion of poorly-differentiated tumors in the right colon. Inflammatory changes were uncommon in rectal lesions; these tumors were more often polypoid than in other locations. Survival was significantly influenced by tumor differentiation, degree of inflammation, macroscopic appearance, and tumor size. Well-differentiated adenocarcinomas, less than 2 cm in diameter, and well-differentiated polypoid adenocarcinomas, less than 4 cm in diameter, were all found in patients with Dukes' stage A tumors. Such patients may be candidates for local excision if the tumor is located in the distal part of the rectum.