Extended low anterior resection with stapled colorectal or coloanal anastomosis.

The use of extended low anterior resection with the aid of the circular stapler for carcinomas of the middle third or upper part of the lower third of the rectum is discussed and salient technical points are emphasized. A collective survey of the results of the operation for such growths has led to the following conclusions: The immediate mortality and morbidity are not excessive. In most cases, even with anastomoses as low as 3.5-4.5 cm from the anal verge, anorectal function eventually reaches a satisfactory state, though there may be quite troublesome diarrhoea and possibly some incontinence during the initial 3-6 months after operation. Adequate data regarding 5-year survival are still lacking, but the high incidence of local recurrence in some reports is perplexing and disappointing and demands continued close attention.