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Posterior transsphincteric rectotomy. Indications and safety.

H H Madsen¹, O Kronborg

¹Department of Surgical Gastroenterology, Odense University Hospital, Denmark.

Diseases of the Colon and Rectum

|December 1, 1987

Summary

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The transsphincteric approach offers a safe surgical option for rectal conditions, including early-stage cancers and adenomas. This method demonstrates low complication rates and preserves anal continence, making it a viable alternative to more extensive surgeries.

Area of Science:

Colorectal Surgery
Surgical Oncology
Gastroenterology

Background:

Increasing detection of small rectal carcinomas and adenomas via endoscopy.
Need for well-established surgical approaches for mid-rectal conditions.

Purpose of the Study:

To highlight the efficacy and safety of the transsphincteric approach for rectal surgery.
To evaluate outcomes including morbidity, mortality, and functional results.

Main Methods:

Retrospective analysis of 30 patients undergoing transsphincteric rectotomy between 1983 and 1987.
Categorization of procedures into curative surgery, adenoma excision, and other indications.
Assessment of complications and functional outcomes (anal continence).

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Main Results:

Zero mortality rate observed.
Low complication rates: 4 wound infections, 4 rectal fistulas.
Preserved anal continence in all patients; temporary flatulence in three.

Conclusions:

The transsphincteric approach is a safe and effective method for rectal surgery in selected patients.
It offers a low mortality and complication rate with preserved anal function.
Recommended as a preferred alternative to major surgery for upper-lower third and mid-rectal lesions.