External coloanal anastomosis without covering stoma in low-lying rectal cancer

The aim of this study was to evaluate the safety and functional outcome of external coloanal anastomosis without covering stoma in treating low-lying rectal cancer. All patients undergoing the coloanal anastomosis for low lying rectal carcer in the Department of General Surgery, Minia University Hospital, between May 2006 and May 2009 were included. Seventy two patients underwent coloanal anastomosis, and follow up was available for all patients. Mean follow up period was 12.6 ± 4.7 months. Postoperatively, fecal continence was normal in 84.7% of patients. Postoperative complications included anastomotic fistula in 3 patients (4.2%) and anastomotic stenosis in 6 patients (8.3%). There was no effect of pre or postoperative adjuvant therapy on the procedure outcome. There was no local recurrence during follow up period. Three patients died at the end of follow up period due to distant metastasis. In treatment of low-lying rectal cancer, abdominoperineal resection should be avoided if coloanal anastomosis provides similar control of the disease as it is safe and has good functional results and acceptable complication rate.