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Unacceptable variation in abdominoperineal excision rates for rectal cancer: a surgeon’s response
  1. M D Clarke
  1. Mr M D Clarke, Consultant Colorectal Surgeon, Friarage Hospital, Northallerton, North Yorkshire, DL8 2NS, UK; mdkmclarke{at}aol.com

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In response to the informative article by Morris et al (Gut Published Online First: 5 June 2008. doi 10.1136/gut.2007.137877) I have looked through the dataset of patients treated by our group. I believe that tumour height is still the key determinant in permanent stoma rate after rectal cancer excision for a colorectal unit and this is demonstrated by analysis of a comprehensive dataset held for our patients.

Two hundred and fourteen patients with colorectal cancer have been treated by the Friarage team, including 73 rectal cancers (15 cm or less from anal verge measured from the caudal extent of the tumour base to the position where the anal verge touches anteriorly on …

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