November 1st 1996
Until 1980, the greatest advances in the management of rectal cancer were technical ones. Whereas in the past most patients with rectal cancer underwent an abdominoperineal resection, it became possible in the 1980s to maintain intestinal continuity in the majority of patients with a low anterior resection and colorectal anastomosis and, more recently, with a low anterio resection and coloanal anastomosis. These advances were due, in part, to the development of stapling devices, which allowed surgeons to perform anastomoses that were technically difficult to perform by hand. More importantly, it became clear that in tumors identified at a relatively early stage, retrograde tumor spread was uncommon, and a 2-cm distal margin was generally adequate.