10. Local Resection of the Small Rectal Tumour

概要

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Small sessile tumour and villous adenoma of the rectum are best treated first by complete local resection. This facilitates thorough examination of the lesion. The nature and the extent of the tumour can be thus accurately revealed. If it is known to be malignant with deep invasion, further radical surgery is mandatory. But, if it is benign or superficial, unnecessary radical operation should be avoided. Technically there are three methods of avail.<BR>1) transanal resection:suitable for low lying lesion.<BR>2) transsphincteric resection (Y. Mason):the exposure is excellent. The sphincter and the levator are divided together with the full-thickness of the rectal wall, but no anorectal dysfunction results, provided that the wound is accurately sutured in layers.<BR>3) transsacral resection (Kraske):the rectum is exposed dividing the levator and pelvic fascia, but the sphincter and puborectalis are retained intact. It also leaves the patient with normal anal function.
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