Management of large encircling mid-rectal adenomas in frail patients

Frail patients with extensive circumferential mid-rectal adenomas should be offered adequate surgery given the risk of local recurrence due to unrecognized malignancy. Accordingly, five poor-risk patients aged 77 years on average underwent segmental resection of the rectum with double stapled anastomosis via the Kraske approach. Tumour length varied from 4 to 5 cm and the distance from the anal verge from 6 to 8 cm. There were no complications aside from five painless incisional hernia. Segmental resection of the rectum via a posterior approach offers adequate treatment with low morbidity and is therefore suitable in frail patients for whom laparotomy may carry unacceptable risks.