Abstract
Proctectomy with Coloanal anastomosis and colorectal anastomosis is the main treatment of rectal cancer even in the lower part of the rectum. The functional results and quality of life are now clearly investigated in the literature. In case of failure to offer the patients comfort and satisfying quality of life, a complete assessment should be proposed (morphological examination (MRI) and anal physiology study). The first goal is to make sure that a cancer recurrence is not responsible for the symptoms. After Cancer recurrence is avoided, conservative management is proposed as a first step of treatment (anastomosis dilations). More aggressive surgical approach (transanal procedures) can be proposed as a second step. Abdominal procedures are more demanding but are allowed to improve the digestive comfort in several cases. Finally, stomia remains a last choice, after failure of anastomosis or in patients with a bad sphincter tone.
Published Version
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