RECTAL TUMORS - TREATMENT WITH A POSTERIOR APPROACH

Treatment of large sessile polyps or tumors of the rectum is a challen ging surgical problem. A retrospective review of the posterior surgica l approach for the treatment of rectal tumors was conducted to assess the efficacy of this operative technique. Thirty-three patients were r eviewed. Thirteen patients underwent transanal excision, and 3 of thes e patients had malignant disease. One patient returned to the operatin g room because of postoperative bleeding. Twelve patients underwent tr anssacral excision of tumors, 6 of which were malignant lesions in the mid to high rectum. One patient developed a fistula. One benign turne r recurred. Eight patients underwent abdomino-sacral excision, and sev en of these were for rectal cancer. Local control was unsuccessful wit h this technique in one patient. There were no deaths in this series. The complication rate was acceptable, and the morbidity of local pain was offset by sphincter preservation and return of normal bowel functi on. This approach seems very useful for a variety of rectal tumors.