Posterior rectotomy for villous tumours of the rectum

Posterior extrasphincteric rectotomy gives good access to the mid-rectum 8-15 cm from the anus. The method is suitable for the excision of villous and adenomatous tumours in this region as it permits radical extirpation and consequently little risk of recurrence. Its chief disadvantage is the risk of a fecal fistula. Among 10 operated patients a fistula was seen in 2; it healed spontaneously in the course of 4 weeks in one but did not heal in the other even after a sigmoidostomy. The latter patient has recurrence of the tumour and an insufficiently radical operation is presumably the reason why the fistula has not healed.