scholarly journals Intersphincteric resection with partial removal of external anal sphincter for low rectal cancer

2008 ◽  
Vol 55 (3) ◽  
pp. 45-53 ◽  
Author(s):  
Y.A. Shelygin ◽  
G.I. Vorobiev ◽  
D.YU. Pikunov ◽  
E.V. Markova ◽  
Y.A. Djhanaev ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Functional Outcome ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Colonic Pouch ◽  
Stoma Closure ◽  
Partial Removal ◽  
Anorectal Reconstruction

Abdominoperineal resection (APR) remains the standard procedure for rectal cancer located within 0.5 cm from dentate line (DL). In this study, we present a new type of restorative surgery: intersphincteric resection with partial removal of external anal sphincter (EAS) and anorectal reconstruction for ultra low rectal cancer. Between March 2003 and May 2008 fifty patients (28 males, aged between 39 and 71) were operated on for ultra low rectal cancer uT2-3N0M0 with partial preservation of EAS and total anorectal reconstruction (smoothmuscle neosphincter and colonic pouch). A protective stoma was performed in all cases. Functional outcome and quality of life were recorded at 3,6,12,18,24 months after stoma closure using Wexner score and FIQL respectively. Anal manometry, vectrum volumetry and myography data were taken as well. Results. Postoperative complications developed in 2 patients, but no secondary surgery was required. Carcinomas were staged as pT2 (n=14) and pT3 (n=36). The distal clearan - ce was 2.00.4(range 1.5-2.8)cm, lateral clearance was 0.80.3(range 0.2-1.4)cm. After a median follow-up of 24 (range 2-61) months, 2 local recurrences were occurred and salvaged by APR. Contractive activity of saved elements of EAS improved with a course of time and squeezing anal pressure increased as well. Perfect functional outcome was achieved in 25 of 34 patients at 12 months after stoma closure, and all the patients were satisfied with procedure. Good functional results of suggested surgery seems to be an acceptable alternative to APR with permanent stoma in selected patients.

scholarly journals Clinical Outcome of Laparoscopic Intersphincteric Resection Combined with Transanal Rectal Dissection for T3 Low Rectal Cancer in Patients with a Narrow Pelvis

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Kimihiko Funahashi ◽  
Hiroyuki Shiokawa ◽  
Tatsuo Teramoto ◽  
Junichi Koike ◽  
Hironori Kaneko
Keyword(s):  
Body Mass Index ◽  
Rectal Cancer ◽  
Local Recurrence ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Stoma Closure ◽  
Bowel Movements ◽  
Laparoscopic Intersphincteric Resection ◽  
Narrow Pelvis ◽  
Observation Period

Purpose. The purpose of this study was to analyze the safety and feasibility of laparoscopic intersphincteric resection (ISR) combined with transanal rectal dissection (TARD) for T3 low rectal cancer in a narrow pelvis.Methods. We studied 20 patients with a narrow pelvis of median body mass index 25.3 (16.9–31.2). Median observation period was 23.6 months (range 12.2–56.7).Results. Partial, subtotal, and total ISR was performed in 15, 1, and 4 patients, respectively. Median duration of TARD was 83 min (range 43–135). There were no major complications perioperatively or postoperatively. Surgical margins were histologically free of tumor cells in all patients, and there was no local recurrence. Excluding urgency, frequency of bowel movements, and incontinence status improved gradually after stoma closure.Conclusion. Laparoscopic ISR combined with TARD is technically feasible for selective T3 low rectal cancer in patients with a narrow pelvis.

Intersphincteric resection with excision of internal anal sphincter for conservative treatment of very low rectal cancer

1999 ◽  
Vol 42 (9) ◽  
pp. 1168-1175 ◽  
Author(s):  
Eric Rullier ◽  
Frank Zerbib ◽  
Christophe Laurent ◽  
Catherine Bonnel ◽  
Michel Caudry ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Conservative Treatment ◽  
Anal Sphincter ◽  
Internal Anal Sphincter ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Very Low Rectal Cancer
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