[Should the posterior approach to the rectum be forgotten?]

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastroenterology

Background:

• High anal fistulas, perirectal tumors, and villous adenomas present surgical challenges.
• The posterior approach is an anatomical surgical technique for rectal conditions.
• Rectal endosonography aids in disease evaluation.

Purpose of the Study:

• To evaluate the efficacy of the posterior approach for treating specific low and mid-rectal conditions.
• To assess the suitability of the posterior approach for select rectal adenocarcinomas in high-risk patients.

Main Methods:

• Utilized a posterior surgical approach for rectal pathologies.
• Performed coccygectomy as a necessary component.
• Did not employ the transsphincteric route.

Main Results:

• Successfully treated 9 cases using the posterior approach.
• Achieved relatively good outcomes in the treated cases.
• Demonstrated the feasibility of the posterior approach for indicated conditions.

Conclusions:

• The posterior approach is a viable and anatomical surgical option for high fistulas, perirectal tumors, and villous adenomas.
• This method can be considered for specific rectal adenocarcinomas in high-risk individuals.
• Careful pre-operative evaluation, including rectal endosonography, is crucial for patient selection.