[Costs and benefits in the follow-up of abdomino-perineal amputation of the rectum for cancer]. / Costi e benefici nel follow-up dopo amputazione addomino-perineale del retto per cancro.

ABSTRACT

A cost/benefit analysis has been carried out of the follow-up of abdomino-perineal amputation of the rectum for cancer in the light of the objectives pursuable with this practice and the diagnostic techniques available today. As regards early diagnosis of a return of the disease, it is necessary to distinguish between long-term recurrence, hepatic or pulmonary for example, in relation to their greater potential capacity for surgical exeresis and local pelviperineal recurrences which are more rarely susceptible to radical exeresis in spite of the introduction of computed tomography and nuclear magnetic resonance in the diagnostic/therapeutic routine. As for diagnosis and management of metachronous polyps as a prevention of metachronous cancer, the importance of periodic trans-stomal pancolonoscopic control of the residual colon in all patients emerges. Finally, in cost/benefit terms, the objective of a psychophysical rehabilitation of the colostomized patient is advantageous with a marked reduction in welfare expenditure for the community.