Abdomino-anal pull-through resection of the rectum

Abstract

Three independent observers have surveyed the results in 158 patients treated by abdomino-anal pull-through excision of the rectum and reached the following conclusions:— The operative mortality of the procedure (4·5 per cent) was low and quite comparable with that following alternative methods of rectal excision.The operation compares favourably with anterior resection and combined excision as a cancer-curing procedure for growths similarly sited in the rectum.Some degree of morbidity following operation occurred in almost half the patients, but significant complications occurred in only about 20 per cent. Colonic necrosis (4·6 per cent) and pelvic sepsis (18 per cent) were the most important. Permanent colostomies were ultimately established in 6 per cent of patients.In the majority of patients the operation was ultimately compatible with good anorectal function. Continence usually improved after about 1 year, though adequate control was often achieved within 6 months. Of those patients with stable bowel function at the time of interview, 89 per cent had a satisfactory result.