[Principles and results of narrow rectum continence resection in cancer]

The special anatomy of the "Rectum-Grenzlamellen" is the reason for justification to carry out a curative sphincter-preserving resection in carefully selected cases. In a small segment just above the pelvic floor muscles there are not any lymphnodes, when the lateral ligaments are divided and the rectum is thoroughly mobilized from the sacral concavity and stretched. The length of rectum below the tumor measured on fixed pinned-out pathologic specimens was about 2 cm. The local recurrences were 6% of 196 cases. The 5-year survival rate of this low restorative resection at St. Marks Hospital was excellent. These results suggest that a margin about 2 cm below a rectal carcinoma does not affect survival or local recurrence adversely.