Kraske-Zugang für Tumoren im kaudalen retrorektalen Raum

The Kraske approach, first described at the end of the 19th century for the treatment of rectal tumours, lost its popularity in favour of rectal resection described by Miles due to the better oncological results. This posterior parasacral approach has once again found its place into the surgical portfolio for the treatment of retrorectal tumours. Thanks to the extensive use of diagnostic imaging, these tumours are increasingly being diagnosed and are now the most common indication for this surgical technique. Most lesions are benign, but primary malignant tumours can also develop, or initially benign masses can degenerate over time. In addition, these are entities that often remain asymptomatic for a long time or show unspecific symptoms and are therefore diagnosed as incidental findings or only after complications have developed. For these reasons, resection is always indicated. If the position is below S3, a posterior approach such as the Kraske approach should be selected. This article describes this surgical method step by step with illustrations. In addition, the pre- and postoperative management and our own results are described.