IS IT TIME TO REVAMP THE POSTERIOR APPROA CH TO THE RECTUM

The posterior approach to the low and mid-rectum is a good and anatomi cal way to treat high fistulas' problems, perirectal tumors and villou s adenoma. It is also possible to treat by this method some rectal ade nocarcinomas in special situations and in high-risk patients. A good e valuation of the disease if possible by rectal endosonography, has to be done. Coccygectomy is necessary but the transsphincteric route is n ot mandatory and has never been used here. 9 cases are reported with r elatively good results.