ABSTRACT
Preop Preoperative colonoscopy to evaluate the entire colon is mandatory in order to
evaluate, tattoo and biopsy all lesions. Rigid proctoscopy should be utilized in the case of lesions in the sigmoid colon or rectum to establish their exact distance from the anal verge, as this effects both surgical planning and possible neoadjuvant treat ment decisions. Functional status in terms of the patients’ continence and quality of life must be assessed preoperatively and utilized in deciding with the patient if this is an appropriate operation for them. Anal manometry should be utilized to quantify the functional status of the sphincter complex. Transanal ultrasound should be used to assess the integrity of the sphincter complex and transrectal ultrasound must be utilized in the case of a rectal neoplasm to document the level of tumor infiltration and the presence of any mesorectal lymph nodes. Dynamic proctography should be obtained if any pelvic floor dysfunction or evacuation disorder is suspected.
