Abstract
This paper describes the technique of partial resection of lower rectal cancer through a transsacral approach. Relatively small lesions in the lower rectum are, in general practice, removed by an endoscopic procedure like polypectomy. When the lesion is diagnosed as sm carcinoma on the examination of the histologic section of resected tissue, the appropriate therapy suited to the individual patient is chosen from among several alternatives. Partial resection of the lesion can be completed without dissection of regional lymph nodes if the patient is negative for such findings as massive invasion of the stump or its neighboring area, vascular invasion, and poorly differentiated adenocarcinoma. Then are several means of access, to the lesion such as trans-anal, -sphincteral, and -sacral resection. We employ transsacral partial resection in situations which would have in the past been transanal or transsphincteral resection. The reason is in addition to providing an unobstructed view, this technique can be easily changed if Dl regional lymph node dissection is necessary during the operation. Furthermore, prior to operation the periphery of the lesion is market stained, and under direct endoscopic control a clip is attached to precisely locate the lesion.
