The Kraske procedure: a critical analysis of a surgical approach for mid-rectal lesions

J Surg Oncol. 2006 Sep 1;94(3):194-202. doi: 10.1002/jso.20591.

Abstract

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.

MeSH terms

  • Adenocarcinoma / surgery*
  • Adenoma, Villous / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cutaneous Fistula / etiology
  • Cutaneous Fistula / surgery
  • Digestive System Surgical Procedures / methods*
  • Electrocoagulation
  • Female
  • Humans
  • Length of Stay
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Proctoscopy
  • Rectal Fistula / etiology
  • Rectal Fistula / surgery
  • Rectal Neoplasms / diagnosis
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Rectum / pathology
  • Rectum / surgery*
  • Retrospective Studies
  • Suture Techniques