[Should the posterior approach to the rectum be forgotten?].

The posterior approach to the low and mid-rectum is a good and anatomical way to treat high fistulas' problems, perirectal tumors and villous adenoma. It is also possible to treat by this method some rectal adenocarcinomas in special situations and in high-risk patients. A good evaluation of the disease if possible by rectal endosonography, has to be done. Coccygectomy is necessary but the transsphincteric route is not mandatory and has never been used here. 9 cases are reported with relatively good results.