Trans-abdominal coloanal anastomosis for low rectal cancer located between 4 and 6cm away from the anal verge

Objective To investigate the effect of trans-abdominal coloanal anastomosis on the treatment of low rectal cancer located between 4 and 6cm away from the anal verge.Methods From November 2001 to December 2005,36 patients with low rectal cancer between 4 and 6cm away from the anal verge underwent partial internal anal sphincter resection and trans-abdominal coloanal anastomosis with double stapling technique.Results The coloanal anastomosis was about 2.5cm above the anal verge.The median follow-up was 23 months. Distant metastasis occurred in 4 patients and no local recurrence was confirmed.Total 3-year survival rate was 100% and tumor-free 3-year survival rate was 84.6%.According to Williams’s classification of continence,among 28 patients after 1 year surgery,23 patients were in GradeⅠ(Perfect),2 patients in Grade Ⅱ (Incontinent of flatus),3 patients in Grade Ⅲ (Occasional minor soiling).Conclusion Trans-abdominal coloanal anastomosis is an optimal sphincter-saving procedure for low rectal cancer located between 4 and 6cm away from the anal verge.Partial internal anal sphincter resection does not compromise the long-term anal function.