title: [Complete removal of the rectum with preservation of continence in rectal cancer].
abstract: Restorative complete rectal excision with coloanal anastomosis was performed in 14 patients (12 cases with rectal carcinoma, i.e. 12% of a consecutive series). The pathologic stages were Dukes D in 3, Dukes C in 5, Dukes B in 2 and Dukes A in 2 patients. A simple technique of hand-sewn end-to-end endoanal anastomosis, following mobilization of the whole left colon in most cases, was employed. The postoperative course was uneventful in 11 of 14 cases, with protective colostomy in 1 patient only. 3 patients developed a presacral infection with a primary colostomy in 2 cases, and with early abdomino-perineal excision in 1 case. 1 patient with a doubtful distal margin and later recurrence refused amputation; salvage amputation became necessary in a patient with a large tumor situated 9 cm above the anocutaneous junction, who developed a locoregional recurrence by tumor implantation. Normal or satisfactory continence was recovered in all patients after a few weeks or months. Presupposing proper selection of cases and surgical technique, complete rectal excision with coloanal anastomosis is regarded as a very useful curative or palliative procedure in the treatment of rectal cancer.
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000601:surgery; D003106:Colon / Q000601:surgery; D005242:Fecal Incontinence / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*
vernacular_title: Vollständige Rektumentfernung mit Kontinenzerhaltung bei Rektumkarzinom.