TOTAL RECTAL RESECTION AND COLOANAL ANASTOMOSIS FOR LOW RECTAL TUMORS- COMPARATIVE RESULTS IN A GROUP OF YOUNG AND OLD PATIENTS

Rectal cancer incidence is increasing among the elderly who are more o ften considered for palliation rather than for surgical cure. Moreover , sphincter-sparing surgery is often avoided when treating the elderly . We report our experience on a consecutive series of 38 subjects, suf fering from a lower third rectal tumour with a median distance of 5.6 cm from the anal verge (7 Dukes' A, 6 Dukes' B, 17 Dukes' C, 3 Dukes' D, 3 anastomotic recurrences and 2 large villous adenomas). All subjec ts were prospectively collected in a 2-year period and treated with to tal resection and cole-anal hand-sewn anastomosis on a J colic reservo ir. 20 patients younger than 65 years and 18 over 65 years were matche d for surgical complications, late morbidity, oncological and function al results but no statistical difference was found. Our hope is that a conservative approach in treating the low rectal tumours will progres sively be accepted for elderly patients.