Abdomino-anal pull-through resection of the rectum

Abdomino-anal pull-through resection of the rectum is one method of achieving resection of carcinomas involving the middle third of the rectum while allowing sphincter conservation. A number of different techniques have been described and are now reviewed along with the reported results with special reference to operative mortality, cancer curing potential, post-operative morbidity, and the quality of post operative function. Considerable variability in the published results and in the experience of different authors has prevented this procedure becoming widely adopted in the past. Its current place in the management of rectal carcinoma is discussed with reference to other sphincter saving techniques, and in particular the use of stapling devices which are now frequently used to achieve anastomosis following resection of low-lying tumours. It is considered that, at the present time, there is little place for abdomino-anal pull-through techniques in the management of rectal carcinoma.