[Modified super anterior resection of rectal carcinoma with transpubic approach].

ABSTRACT

To ensure good exposure of operative field and to reduce the complications of low anterior resection of rectal carcinoma with transpubic approach, we modified Ackerman's method and operated on 18 patients with middle and lower rectal carcinoma at the level of 4-8 cm above the anus. 1cm width of the inferior part of the pubic symphysis was preserved. Results were compared with 19 patients operated on in the original way. Dissection of the arcuate ligament, penis suspensory ligament and penis nerve under the lower pubic margin was avoided, so that cyanosis of the penis, perineum and occurrence of sexual dysfunction were reduced, and the period of postoperative pain was shortened. 89% of patients operated in this way enjoyed good defecating function. We suggest that this procedure is indicated in all patients with rectal carcinoma located 4-7 cm above the anus with the exception of mucinous carcinoma.