[Posterior rectotomy--a minimally invasive procedure?].

This study included twenty-five consecutive patients, 12 men and 13 women, treated with a posterior approach to the rectum because of diseases in the mid and lower third of the rectum. Surgical indication included rectovaginal fistula in four patients, villous adenoma in 13 patients, villous adenoma containing carcinoma in three patients, primary carcinoma in four old high-risk patients and recurrent cancer in one old high-risk patient. There were only a few minor postoperative surgical complications, one wound infection and one rectal bleeding from the place of the excision. The bleeding was treated transanally. Three patients developed pneumonia. No patients died as a complication of the procedure. The posterior approach provides excellent exposure for complete removal of tumour in the mid- and distal part of the rectum, and the results of this study indicated that the technique has a place in the management of various benign and selected malignant conditions in the mid and lower third of the rectum. The procedure is easy to perform, safe with only a few minor complications and well tolerated even in old high-risk patients.