[Basic principles of rectal excision].

Abstract

Rectal excision has decreased by half in favour of anterior resection of the rectum. The following points should be observed during operation: (1) dissection close to the rectal wall to avoid injury to the sacral veins and nerves for both bladder and sexual function; (2) ligature of the sup. rectal artery; ligature of the inf. mesent. artery has not been established to be advantageons; (3) avoidance of tumor perforation; (4) primary occlusion of the sacral cavity with extravulnar suction drainage. The results are as follows: 5-6% death rate in the literature and 2.4% in our own patients; bladder dysfunction in 3.5-59%; sexual dysfunction 14-36%; impotence 14-28%; local recurrence 39-57% with and 34% without perforation.