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KMID : 0356719960120010127
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Journal of the Korean Society of Coloproctology
1996 Volume.12 No. 1 p.127 ~ p.135
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Surgical Approach to Tumor of Rectum & Retrotectal Space - Posterior rectotomy -
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Kim Jung-Mook
Kim Heung-Dae
Kim Kwang-Youn
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Abstract
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Most cases of rectal cancer and retrorectal tumor are treated by radical excision, but these operation are were more extensive and may be followed by serious complication for selected malignant tumors and benign lesions. Posterior approach was developed by Verneuil(1873), Crimps(1987), Kraske(1885), Bevan(1913) and Mason(1970). This technic
of direct surgical approach to lesions of the rectum and retrorectal space is presented, including 36 cases successfully managed at the Department of Surgery, Kangbuk Samsung Hospital from January 1970 to December 1993.
Results were as follows:
1) The age of the patients ranged from 30 to 80 years.(mean: 56 years old)
2) Of the 36 cases, male and female ratio was 1 : 1.
3) Kraske’s technique was performed in 8 cases and Mason’s technique in 28 cases.
4) 5 complication were developed in the 36 patients including 3 wound infection, 1 temporary anal incontinence and 1 rectocutaneous fistula.
5) Postoperative pathologic diagnosis revealed that 13 were villous adenoma, 12 were adenocarcinoma, 11 were benign or malignant lesions on rectum or retrorectal space.
6) According to TNM stage, 12 adenocarcinomas was distributed into stage 0∼7 cases, stage I-4 cases and stave Ⅱ-1 case.
7) 4 cases were reoperated after posterior approach which were 2 abdominoperineal resection, 1 stapled anterior resection, and 1 explo-lapa and mass excision.
8) Recurrence of tumor after first operation was 3 cases which were 2 adenocarcinoma and 1 leiomyosarcoma.
In conclusion, Posterior approach is one of the best surgical options to the lesions that was developed on the low, mid rectum and retrorectal space.
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KEYWORD
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Rectal Neoplasms, Retrorectal Tumor
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