Abstract
In the decade from 1981 to 1990, 30 patients underwent a posterior transsacral approach at the Aichi Medical University Hospital for their benign or malignant rectal lesions. The operation was classified into two procedures, consisting of the transsphincteric approach and transsacral approach, in order to cope with the condition of the anal sphincter muscles; whether they were divided or not. Eleven rectal tumors were successfully excised through the opened-up rectum by using the transsphincteric approach, and excellent results were obtained without any postoperative complications. Using the transsacral approach, 2 presacral dermoid cysts and 11 rectal lesions were easily removed under direct vision. Their prognoses were excellent. The transsacral approach was also applied for the resection of recurrent rectal cancers after a radical abdominoperineal resection in 6 patients suffering from intolerable local symptoms. All the patients were free from these uncomfortable local symptoms after the surgery. The posterior transsacral operation is thus considered to be of value not only for resecting benign rectal and presacral lesions, but also for resecting malignant rectal tumors in frail subjects who are unfit for radical operation and/or recurrent rectal cancer.
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Bevan AD (1917) Carcinoma of rectum: Treatment by local excision. Surgical Clinics of Chicago 1:1233–1239
Moran TF (1961) Transsacral removal of rectal lesion. J Intl Coll Surgeons 35:361–370
Parks AG, Stuart AE (1973) The management of villous tumors of the large bowel. Br J Surg 60:688–695
Lockwood RA, Tayler WA (1956) Posterior surgical approach to the rectum. California Med 85:104–106
Deddisher MR, Stearms MW (1961) Anterior resection for carcinoma of the rectum and rectosigmoid area. Ann Surg 154:961–966
Miles WE (1908) A method of performing abdominoperineal excision for carcinoma of the rectum and terminal portion of the pelvic colon. Lancet II:1812–1813
Mason AY (1970) The place of local resection in the treatment of rectal carcinoma. Proc Roy Soc Med 63:1259–1262
Crowley RT, Davis DA (1951) A procedure for total biopsy of doubtful polypoid growths of the lowest large bowel segment. Surg Gynec Obst 93:23–26
Localio SA, Eng K, Ranson J HC (1980) Abdominosacral approach for retrorectal tumors. Ann Surg 191:555–559
Wanebo HJ, Marcove RC (1981) Abdominal sacral resection of locally recurrent rectal cancer. Ann Surg 194:458–471
Takagi H, Morimoto T, Kato T, Yasue M, Hara S, Suzuki R (1985) Diagnosis and operation for locally recurrent rectal cancer. J Surg Oncol 20:290–296
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Kanemitsu, T., Kojima, T., Yamamoto, S. et al. The transsphincteric and transsacral approaches for the surgical excision of rectal and presacral lesions. Surg Today 23, 860–866 (1993). https://doi.org/10.1007/BF00311362
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DOI: https://doi.org/10.1007/BF00311362