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Posterior surgical approaches to the rectum
Annals of Surgery
|June 1, 1982
Summary
Posterior rectal approaches, including Kraske and Mason procedures, are safe and effective for benign and selected rectal conditions. Most patients achieved fecal continence with minimal complications, demonstrating the procedure
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Posterior surgical approaches offer access to the rectum.
- Trans-sacral (Kraske) and trans-sphincteric (Mason) are key posterior techniques.
Observation:
- Nineteen patients (12 male, 7 female) underwent posterior rectal procedures.
- Indications included villous tumors (9), benign issues (4), primary (3), and recurrent rectal cancer (3).
- Age range was 18 to 89 years.
Findings:
- Eight complications occurred: 4 fecal fistulae, 2 wound dehiscences, 1 rectal stricture, 1 sacrococcygeal hernia.
- Fecal fistulae resolved spontaneously in 2, required colostomy in 2.
- Fecal continence was achieved in 18/19 patients; no mortality or tumor recurrence reported.
Implications:
- Posterior rectal approaches are safe and effective for benign and selected malignant rectal conditions.
- These techniques are ideal for villous tumors and small, exophytic, mobile rectal carcinomas.
- The procedures demonstrate good functional outcomes and low complication rates.