Ann Coloproctol.  2018 Aug;34(4):167-174. 10.3393/ac.2018.08.02.

Intersphincteric Resection for Patients With Low-Lying Rectal Cancer: Oncological and Functional Outcomes

• Park IJ
• Kim JC

• KMID: 2422078
• DOI: http://doi.org/10.3393/ac.2018.08.02

Abstract

The aim of this review is to evaluate the outcomes after an intersphincteric resection (ISR) for patients with low-lying rectal cancer. Reports published in the literature regarding surgical, oncological, and functional outcomes of an ISR were reviewed. The morbidity after an ISR was 7.7%-32%, and anastomotic leakage was the most common adverse event. Local recurrence rates ranged from 0% to 12%, 5-year overall survival rates ranged from 62% to 92%, and rates of major incontinence ranged from 0% to 25.8% after an ISR. An ISR is a safe procedure for sphincter-saving rectal surgery in patients with very low rectal cancer; it does not compromise the oncological outcomes of the resection and is a valuable alternative to an abdominoperineal resection. While the functional outcomes after an ISR were found to be acceptable, the long-term functional outcome and quality of life still require careful investigation. ISRs have been performed with surgical and oncologic safety on patients with low-lying rectal cancer. However, patients must be selected very carefully for an ISR, considering the associated functional derangement and the limited extent of the resection.

Keyword

Low-lying rectal cancer; Intersphincteric resection; Oncologic outcome; Functional outcome

MeSH Terms

Anastomotic Leak
Humans
Quality of Life
Rectal Neoplasms*
Recurrence
Survival Rate