Introduction: In the surgery of tumors under peritoneal the need to remove all the meso rectum for the purpose of obtaining the radicality of cancer, by packaging an anastomosis that falls near the muscular plane of the elevators of the anus, is now a consolidated procedure. Anal anastomosis has considerable technical difficulties, especially when it is performed by hand, especially in obese patients with a narrow and deep pelvis. These unfavorable conditions contribute to predispose the patient to the onset of complications for which it is preferable in principle to perform a mechanical anastomosis. Materials and methods: From January 2010 to December 2017, the database of the University of Catania Polyclinic AOU was investigated in 37 cases of tumor-site neoplasm in the sigma-rectum. A age of 72 years (range 74-70). On the clinical examination there was blood in the stool accompanied or not by diarrhea and constipation, asthenia, malaise, rapid weight loss and anemia. Results: The tumor was found to be between 4 and 10 cm from the rhyme, such a neoplasm had a max diameter of between 3 to 5 cm, the macroscopic appearance of the neoplasm was 70% vegetative and polypoid or pedunculate and sessile for the remaining 30%. The definitive histological examination confirmed the ultrasound diagnosis with a demonstrated sensitivity of 95%. Discussion: In the execution of the resection intervention, two main times are schematically distinguished, the abdominal time in which the rectum mobilized in the abdomen is sectioned freehand on the plane of the anus lifters. Why this is possible It is necessary to point out how the mobilization is made broad and invests the splenic flexure and part of the transverse colon in order to allow an easy lowering of the colon in the pelvis. The flap of the big oment is pushed and placed in the pelvis to fill the void created by the removal of the rectum. The results obtained also demonstrated in our case studies as the observation of the few rules implemented and illustrated, the therapeutic success was assured in relation to the containment of the risk of complications, morbidity and mortality. Conclusion: The colon anal anastomosis in compliance with oncological criteria have proved to be current and feasible. In spite of the fact that a widely demolition procedure is performed, it is possible to conserve the sphincter anal apparatus so as to ensure an acceptable quality of life.
