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The Kraske procedure: A critical analysis of a surgical approach for mid‐rectal lesions
Author(s) -
Onaitis Mark,
Ludwig Kirk,
PerezTamayo Anthony,
Gottfried Marcia,
Russell Linda,
Shadduck Phillip,
Pappas Theodore,
Seigler Hilliard F.,
Tyler Douglas S.
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20591
Subject(s) - medicine , surgery , laparotomy , colostomy , complication , villous adenoma , general surgery , rectum
Background and Objectives To analyze the Kraske procedure as an approach to mid‐rectal disease. Methods Twenty‐two patients underwent a Kraske procedure at either Duke University Medical Center, the Durham Veterans Administration Medical Center, or the Durham Regional Hospital between 1992 and 1997. The clinical and pathologic characteristics of these patients were retrospectively analyzed and compared with previous published series. Results Of the 22 patients, 13 underwent resection of an adenocarcinoma and 9 underwent resection of a villous adenoma. Post‐operative complications included four fecal fistulas (two of which required a temporary diverting colostomy), two wound infections, two cases of urinary retention, and one case of transient fecal incontinence. Conclusions The Kraske procedure minimizes exposure of mid‐rectal lesions without the morbidity of a major laparotomy. However, it does carry a moderate complication rate and thus should be utilized selectively in managing patients with mid‐rectal tumors not amenable to other treatment options. J. Surg. Oncol. 2006;94:194–202. © 2006 Wiley‐Liss, Inc.