These sixty five cases of abdomino-trans anal excision account for approximately one third of 210 operations performed for carcinoma of the rectum. In the context of curative surgery, indications for preservation of the sphincter must be strict in order to permit satisfactory excision inferior to the tumour and to avoid the risk of local recurrence. Post-operative care and early complications involve the segment of colon which must be brought down. Gangrene of the exteriorised colon did not, in general, compromise the definitive result, at the price of an early colostomy which could always be closed later. Long term results are encouraging: 22 patients out of 26 who underwent non-palliative surgery are alive, without recurrence, after 5 years. The functional result can be assessed only after 6 months adaptation. One patient in two considers himself to be normal. The other half are forced to used enemas, and one in four must wear a protective dressing.
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