J.Jpn. Surg. Soc.. 91(9): 1121-1124, 1990

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Report on the annual meeting

ADVANCE OF COLORECTAL SURGERY 1970ー1989

The colorectal surgery advanced remarkably in many respects during the last two decades in Japan. Ulcerative colitis has been no more rare since 1970's and the number of patients operated on has increased year by year. The operative mortality has been decreased as the emergency operation became uncommon. Instead of total proctocolectomy with ileostomy ileorectal anastomosis was widely adopted untill about 1985, thereafter ileoanal anastomosis became most preferable because the technical difficulties were overecome.
As to the colorectal cancer, extended resection associated with lymphadenectomy was done mainly during the period and it was proved to be effective to get better survival, especially for low lying rectal lesions. On the other hand, low anterior resection and more conservative surgery, such as local resection were done in selected patients. Low anterior resection is the operation of choice in more than 50% of rectal cancer at present. More over, pelvic autonomic nerve preserving operation was induced into the radical treatment to avoid the postoperative urinary and sexual problems. Local and hematogenous metastases are yet remaining difficult to manage but surgery and multimodal therapy are on the progress.

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