EVALUATION OF 18 CASES OF CONSERVATIVE PROCTECTOMY WITH LOW TRANSSECTION OF THE ANORECTUM FOR BENIGN-DISEASES

Objective: To present our experience of conservative proctectomy in th e treatment of patients with benign diseases of the rectum. Design: Re trospective study. Setting: University hospital. Subjects: 18 patients with benign diseases of the rectum for whom a pouch was unsuitable. I nterventions: Conservative proctectomy with transsection of the anorec tum. Main outcome measures: Mortality and morbidity. Results: In 10 pa tients the wounds healed primarily. The remaining 8 developed presacra l abscesses, which drained either spontaneously or after a drainage op eration. At the end of the 19 month follow up period four still had pr esacral cavities with fistulas to the anal canal, and one patient had died of a cause unrelated to the operation. No patient complained of s exual dysfunction. Conclusion: If proctectomy is indicated for a benig n disease a limited excision with transsection of the anorectum at the pectinate line is safe if the closed anal canal is examined carefully and residual mucosa removed. It should not be used for patients with severe inflammatory or fibrous changes in the perirectal tissue.