The choice among anterior resection, the pull‐through, and abdomino‐perineal resection of the rectum

For clinically infiltrating cancer of the rectum below 6 cm from the anal verge, abdominoperineal resection is our operation of choice, although in very highly selected patients a sphincter‐preserving procedure has given satisfactory results. For cancer between 6 and 11 cm, a sphincter‐preserving procedure, when it can be done, is our choice. Anterior resection in our hands has given better long‐term functional results and has been our preference. Occasionally a pullthrough can be done when anterior resection is technically impossible. In almost a quarter of patients with cancer in this area, abdominoperineal resections are done when sphincter‐preserving procedures cannot be done for anatomical or technical reasons.