title: Posterior approach to the rectum for treatment of selected benign lesions.
abstract: Access to lesions in the mid-rectum can be difficult. This report summarizes our experience with a posterior approach to the rectum in 22 men and 13 women, age range 21 to 96 years. Surgical indications included villous tumours, rectal prolapse, rectal strictures or rectal fistulae. No postoperative complications were observed in 20 patients, but fistulae developed in seven patients, of whom three required proximal colostomy and surgical treatment. Four healed spontaneously. Two patients developed sacrococcygeal hernia. Pathologic examination of villous tumour showed extensive malignant change in three cases requiring rectal resection with end-to-end colo-anal anastomosis. In two patients mild incontinence developed, treated by biofeedback. Residual peri-anal pain was reported by two patients. The posterior approach to the rectum is particularly useful for benign lesions too high for a transanal resection and too low for a transabdominal resection.
authors.affiliation: Service de Chirurgie Digestive, Hôpital Sainte Marguerite, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Arnaud
authors.forename: I R
authors.initials: IR
authors.lastname: Fretes
authors.forename: A
authors.initials: A
authors.lastname: Joly
authors.forename: J C
authors.initials: JC
authors.lastname: Sarles
mesh_terms: D000236:Adenoma / Q000453:epidemiology / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012003:Rectal Fistula / Q000601:surgery*; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D012005:Rectal Prolapse / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013997:Time Factors