Abstract
Historically speaking, treatment of rectal cancer has been based on the stage of the tumor at presentation and its height in the rectum. In the past treatment was an abdominal perineal resection with end permanent colostomy. That being the case, it made perfect sense to measure tumors from the anal verge. This was typically done with a rigid sigmoidoscope so that a constant measurement could be obtained. Anatomically however, there is a high variability in the length of the anal canal. The canal itself can be anywhere from 5mm to 5 cm in length depending upon the size and physique of the patient. The anal verge is where the epithelialized skin is encountered. The proximal margin of the anal canal is at the anorectal ring. The dentate line marks the midpoint. Therefore, a tumor at the 5 cm level measured from the anal canal could range anywhere in this location from the mid rectum to the upper aspects of the anal canal, depending on the anal canal length.
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Marks, J.H., Nassif, G.J., Marks, G. (2012). Transanal abdominal transanal proctosigmoidectomy with descending coloanal anastomosis (the TATA procedure) for low rectal cancer treated with chemoradiation. In: Schiessel, R., Metzger, P. (eds) Intersphincteric Resection for Low Rectal Tumors. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0929-8_15
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DOI: https://doi.org/10.1007/978-3-7091-0929-8_15
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