|Posterior approach||Transabdominal approach|
- Short distance to the tumor.|
- Direct dissection around the coccyx or levator ani muscle.
- Coccygectomy can be added.
|- Cranial side of large tumors (> 10 cm) can be exposed easily.|
- Risk of injury to hypogastric nerves and median sacral vessels.|
- Exposure of the cranial side of the tumor is difficult.
- Dissection around the lower rectum is difficult.|
- Risk of injury to proximal part of the mesentery (which may require resection of the rectum and/or stoma creation).
- Risk of peritoneal dissemination.
- Risk of adhesive intestinal obstruction.