68 Patienten wurden auf parasakralem posteriorem Weg wegen eines Rektumkarzinoms operiert. Die Nachsorge von 40 Patienten zeigte eine höhere Rezidivquote, als dies nach abdominoperinealer oder defer vorderer Rektumresektion beschrieben wird. Mit chirurgischer Geschicklichkeit werden eine Durchtrennung oder Beschädigung der Sphinkteren sowie Komplikationen mit analer Inkontinenz fast immer zu vermeiden sein. Wenn man die Vorteile einer kurativen Chirurgie in bezug auf postoperative Letalität mit dem parasakralen posterioren Zugang abwägt, erscheint das posteriore Verfahren beim alten Hochrisikopatienten eine vernünftige Alternative zu sein. In Zukunft könnten weniger toxische, aber dafür effektive adjuvante Therapien den lokalen Eingriffen wie dem parasakralen posterioren Operationsverfahren zum Durchbruch verhelfen.

Keywords:
Rektumkarzinom, Kontinenzerhaltende Chirurgie, Parasakraler Zugang
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© 1995 S. Karger AG, Basel
1995
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