Peranal sleeve anastomosis for low rectal cancer.

Over a 3-yr period, 13 patients underwent surgery for a rectal tumor located between 5 and 7 cm from the anal verge. We modified Parks' procedure for a peranal sleeve anastomosis in order to avoid tension and retraction. Until now, the preferred operation for tumors at this location was abdominoperineal excision as devised by Miles. In the light of present-day knowledge, some of the lesions situated at a slightly lower level in the midrectum can be treated with a less mutilating surgical approach which is associated with continence and satisfactory sphincter function. There was no postoperative mortality. During a 5-yr follow-up period, 2 of the 13 patients died; there was no recurrence of local tumors.