[Mason paracoccygeal trans-sphincteric approach to the rectum: good outcome only in highly selective indications?]

From 3/1985 until 10/1993, a total of 10 patients were operated using the Mason approach. Four patients undergoing resection of flat villous adenomas situated on the anterior wall of the lower and mid third of the rectum, and one patient with adenoma situated on the posterior wall of the upper third, all of them with reconstruction using intact rectal wall portions, enjoyed a smooth postoperative course, continence and absence of recurrence. Two patients operated for presacral local recurrence following rectal excision and rectal prolapse, respectively, suffered recurrence after a smooth early course. Two patients undergoing resection of villous adenomas situated on the posterior wall of the lower and mid third with reconstruction using denudated muscle wall and one patient undergoing segmental resection for radiogenic rectovaginal fistula developed complex fecal fistulae. On the basis of these experiences and the pertinent literature, indications promising uniformly good results were defined.