Surgery of colorectal cancer

Studies on lymphatic spread of rectal cancer have established the rationale for sphincter preservation in the treatment of midrectal cancer. This entity comprises lesions located 5.5 to 10 cm above the anal verge in women and 7 to 11 cm in men. Abdominosacral resection is a logical means for restoring intestinal continuity after radial resection for midrectal cancer. Direct posterior exposure of the distal limit of resection above the pelvic floor allows accurate construction of the anastomosis without disturbing the anorectal structures or their innervation and maintains essentially normal anal continence. The procedure is preferable to the various pull-through operations. Survival rates for patients undergoing anterior resection, abdominosacral resection and abdominoperineal resection are comparable.