Once the diagnosis of Cancer has been established, certain critical tests are needed to determine the most appropriate course of action. One of the most important things to know is the exact distance of the tumor from the anal verge since this determines whether the sphincter can be preserved. This is best determined by rigid proctoscopy. One needs to obtain a 2 centimeter distal margin below the tumor in order to not compromise recurrence and eure rates. As such, most Cancers within the distal rectum (0–5 cm) cannot be treated with sphincter pres-ervation unless certain favorable features are present (see “G”). Most lesions within the mid-rectum (5–10 cm) can be resected with sphincter preservation provided the body habitus of the patient and the surgeon’s skill permit a low dissection and anastomosis within the pelvis.
KeywordsLocal Recurrence Rate Anal Verge Abdominoperineal Resection Distant Disease Sphincter Preservation
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