RETROGRADE SPREAD OF CARCINOMA IN THE RECTUM AND RECTOSIGMOID

Abstract

SINCE knowledge concerning the frequency, extent and nature of retrograde spread¹ of carcinoma in the rectosigmoid and rectum is still incomplete, many surgeons are uncertain of the surgical procedures offering the most promise to the patient. However, those surgeons who are most radical in their practice point to a lesser number of recurrences in patients so treated when compared to those who have been less radically treated. The question therefore arises of whether increased incidence of recurrence in the less radically treated patients may not be due to preoperative retrograde spread from the portion of the bowel removed to the portion left behind. Attempts to answer this question appeared in the literature of 1913 and 1914.² It was shown that in approximately 20 specimens retrograde spread occurred from 1 to 2 cm. below the lesion. However, the method of study was inadequate since examination was limited to a