Straight Colorectal and Coloanal Anastomosis

Restoration of intestinal continuity and function is an essential element of rectal surgery. For over three decades, the use of anterior resection with rectal reconstruction has been increasing while the use of abdominoperineal resection (APR) has declined [81]. Technical advances in the creation of low anastomoses have contributed significantly to this trend [27, 64]. In most rectal resections, colorectal or coloanal anastomosis can be accomplished rapidly and safely. In cases where reconstruction is not advisable, the barrier is generally oncologic rather than technical. As a result, low anterior resection (LAR) is now the primary surgical treatment for rectal cancer. In some specialty centers, the use of abdominoperineal excision has declined to less than 10% of resections for primary rectal cancer [47].