A new sphincter-splitting operation for surgical access to low-lying tumors of the rectum

Fifty-eight patients underwent anterior anorectotomy for removal of intrarectal tumor. The mean age of patients was 69 years: 33 were over 70.26 tumors were benign and 32 malignant. There were no postoperative deaths during hospital stay or the 30 days following discharge. Six abscesses and 2 self-limiting urethral fistulas were diagnosed in 2 male patients. The wound healed at day 14 on the average. Sphincter function was judged to be poor or average in 2 cases each and normal in the remaining 54. One patient had local recurrence at 6 years, amenable to reoperation. Five patients died of their cancer between 10 months and 2 years. Anterior anorectotomy permits exposition up to 14 cm from the anal verge, is not mutilating, can be performed under spinal anesthesia, and is recommended for removal of benign rectal tumors as well as small carcinomas in patients physically or mentally unfit for major abdominal surgery.