Long-Term Results of Intersphincteric Resection for Low Rectal Cancer

ABSTRACT

Background: The aim of this study is to investigate the long-term therapeutic outcome of intersphincteric resection (ISR) as the treatment of ultra-low rectal cancer. Methods: During January 2004 and October 2010, ISR was performed in 60 patients with ultra-low rectal cancer and their survival, local recurrence, and functional outcome were evaluated retrospectively. Results: A total of 60 patients with tumors at a median distance of 42 (range 30–50) mm from the anal verge underwent ISR. Three cases developed anastomotic leakage and two cases developed anastomotic stenosis postoperatively. After a median follow-up of 49 (range 18–90) months, local and distant recurrence occurred in six and four patients, respectively. Five-year overall and disease-free survival rates were 90.0% and 83.3%. Among them, the functional results of 53 patients suggested the mean stool frequency were 3.8 ± 1.3 (range 3–10) per 24 hr. According to Kirwan classification, good continence was shown in 73.6% of the patients. Conclusion: This preliminary study indicated that ISR might be a candidate technique in treating patients with ultra-low rectal cancer and achieved satisfactory long-term results in functional and oncologic respects.

Keywords: :

• ultra-lower
• rectal cancer
• intersphincteric resection
• anal function
• oncologic outcome
• sphincter-saving technique