Fueled by a greater understanding of pelvic physiology along with an improved comprehension of rectal cancer spread, we are now able to offer most patients restoration of intestinal continuity following oncologic proctectomy. Coloanal or ultralow colorectal anastomosis can be performed in most patients with midrectal cancers, provided that anal sphincter function is not impaired preoperatively. Functional results may be improved by construction of a colonic pouch with pouch-anal anastomosis. Temporary fecal diversion, usually with a diverting loop ileostomy, may be prudent, especially in patients undergoing neoadjuvant chemoradiation.
Read TE, Kodner IJ. Proctectomy and Coloanal Anastomosis for Rectal Cancer. Arch Surg. 1999;134(6):670–677. doi:10.1001/archsurg.134.6.670
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: