[Foundation, technique and results of short continence resection in rectal cancer]

Abstract

Ultra-short resections of the rectum have been recommended for rectal carcinomas extending to lower than eight cm from the dentate line in order to preserve anal continence. Resection of the main lymphatic pathways together with the adjacent lamellae is important for radical removal of all tumour cells. Valves in the rectal lymph vessels allow lymph fluids to drain only in a cranial direction. There are no lymph nodes behind the dorsal adjacent lamella. Thus, a distal margin of two cm from the tumour is sufficient to minimize the risk of recurrence. We recommend a transano-abdominal approach for very low rectal carcinomas. During the past years, we have operated on 241 patients with rectal carcinomas and found five-year-survival rates of 54 percent with rectum resections with colostomies, 67 percent with low anterior resections and 75% with ultra-short sphincter preserving resections.