Rectal tumors: treatment with a posterior approach

Treatment of large sessile polyps or tumors of the rectum is a challenging surgical problem. A retrospective review of the posterior surgical approach for the treatment of rectal tumors was conducted to assess the efficacy of this operative technique. Thirty-three patients were reviewed. Thirteen patients underwent transanal excision, and 3 of these patients had malignant disease. One patient returned to the operating room because of postoperative bleeding. Twelve patients underwent transsacral excision of tumors, 6 of which were malignant lesions in the mid to high rectum. One patient developed a fistula. One benign tumor recurred. Eight patients underwent abdomino-sacral excision, and seven of these were for rectal cancer. Local control was unsuccessful with this technique in one patient. There were no deaths in this series. The complication rate was acceptable, and the morbidity of local pain was offset by sphincter preservation and return of normal bowel function. This approach seems very useful for a variety of rectal tumors.