Abdominotransanal approach in the treatment of the low-lying rectal carcinoma

Seven patients with non advanced cancer of the lower third of the rectum underwent sphincter-saving resection through a combined abdominoperineal approach. In this procedure not only coloanal anastomosis, but also bowel transection were performed through the anus. All the patients had cancer located between 3.5-5.5 centimeters from the anal verge. The main advantages of the technique are precise lines of bowel transection with desired distal clearance of tumor, and easier and safer mobilization of the distal end of the rectum during the abdominal phase of the procedure. No mortality was observed; morbidity was comparable to low anterior resection. The mean follow-up is 8 months and all patients are free of recurrence and continent.