Sphincter preservation and low rectal carcinoma: interest for a prospective trial

Rectal adenocarcinoma located less than 6 cm from the pectineate line raise the issue of sphincter preservation. Preoperative treatment response can modify the initial indication of surgery. With good response, conservative surgery can be performed with a distal margin less than 2 cm. Conversely a lack of response requires an abdominoperineal resection. Removal technique must emphasize a total mesorectal excision and a prevention of urosexual complications. Intersphincteric resection allows to increase distal margin without continence dysfunction. Regional lymphadenectomy doesn't increase regional control Digestive tract reconstruction combines coloanal anastomosis and J colonic pouch therapeutic approach.