Excision of rectal lesions by the Kraske approach

Abstract

The Kraske operation is a little used procedure which has value in the treatment of selected benign lesions of the rectum below the peritoneal reflection. The operation is especially suitable for broad-based villous tumors or large adenomatous polyps. Total excision of villous tumors is essential to obviate invasive cancer and to prevent recurrence. The principal complication of the posterior proctectomy is the development of proctocutaneous fistulas (four of twenty cases). In three of the four cases the fistulas closed spontaneously. The Kraske operation is curative for villous adenomas showing atypia or carcinoma in situ and probably is sufficient treatment for tumors showing superficial foci of adenocarcinoma, but it should be emphasized that there is still no place for this procedure in the treatment of invasive carcinoma.