الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Colorectal carcinoma is the third leading cause of death from cancer in both males and females. Surgical treatment of rectal cancer still has serious problems both in local control and quality of life after surgery: high local recurrence rate with loss of the anal sphincter, disturbance of defecation and urinary and sexual dysfunction. Introduction of total mesorectal excision followed by (immediate or delayed) restoration of bowel continuity is now the standard surgical practice for cancer mid & lower rectum. Experience from many centers has shown that sphincterpreserving resections for midrectal and selected distal rectal cancers provide excellent results, equivalent to those achieved by an APR Consequently, low anterior resection has replaced abdominoperineal resection as the principal operation for rectal cancer. Ultralow resections using coloanal reconstructions in carefully selected patients can also provide excellent results. Impotence after nervesparing dissections has been reported in 10 to 28% of all patients and in 10 to 15%of patients younger than 60 years. Sexual dysfunction is more common in patients treated by abdominoperineal resection. Currently surgeons have embarked upon efforts to design operation that combine adequate pelvic resection and nerve preservation. no cases of serious urinary dysfunction following TME, and most reported cases are transitory in nature. The autonomic nervepreserving total mesorectal excision (TME) technique has proven to reduce local recurrence rates from up to 35% to less than 10%, whilst preserving urogential function