Survival and functional and oncological outcomes following intersphincteric resection for low rectal cancer: short-term results

Objective This study was performed to evaluate the 1-year survival rate and functional outcomes of 20 patients who underwent intersphincteric resection (ISR) for low rectal cancer. Methods Twenty patients who underwent ISR for low rectal cancer were followed up for 1 year. Complications, functional outcomes objectified by the Wexner score, and oncological outcomes were assessed. Results The short-term survival rate was 100%. The median Wexner score was ≤10 in all patients at 12 months after surgery. Signs of local recurrence were absent, and antigen levels remained within the reference ranges 1 year postoperatively. Conclusions ISR is a feasible alternative in highly selected patients who primarily refuse a colostomy bag and present with type II or III tumors. In the present study, patient-reported continence was satisfactory, and the absence of a colostomy bag increased patients’ quality of life. The oncological outcomes were satisfactory at 1 year postoperatively.

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Comparation of Laparoscopic Intersphincteric Resection and Abdominoperineal Resection for Ultra-Low Rectal Cancer Patients - a Retrospective Analysis, and a Meta-analysis of Oncology Outcome

10.21203/rs.3.rs-35748/v1 ◽

2020 ◽

Author(s):

Xianwei Mo ◽

Wentao Wang ◽

Haiquan Qin ◽

Hao Lai ◽

Zigao Huang ◽

...

Keyword(s):

Rectal Cancer ◽

Survival Rate ◽

Retrospective Analysis ◽

Cancer Patients ◽

Abdominoperineal Resection ◽

Meta Analysis ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Complication Rates ◽

Laparoscopic Intersphincteric Resection

Abstract Purpose The aim of the study is to evaluate the surgical and oncology outcomes between laparoscopic Intersphincteric Resection (LISR) and laparoscopic-assisted Abdominoperineal Resection (LARC) for ultra-low rectal cancer patients by using a retrospective analysis, and a meta-analysis of the literature was carried out to further validate the oncology outcome. Patients and methods: Between April 2014 and December 2015, a total of 38 rectal cancer patients who underwent LISR and 41 LARC patients were enrolled in this study. The comparison between the groups was based on clinicopathological characteristics and surgical outcomes. Meta-analysis of published studies, exploring oncology outcome of between LISR and LARC, was carried out using STATA 12.0 software. Results Operating time, blood loss, length of hospital stay, and postoperative complication rates was similar between LISR group and LARC group; Patients undergoing LISR also had a similarly 5-year local recurrence and overall survival rate with LAPR. Meta-analysis showed that five studies, which included a total of 791 patients were final involved for this analysis. Comparing APR, ISR patients obtain similarly 5-years recurrence rate and 5-years survival rate. Conclusion This study suggests that LISR is as technically feasible, safe, and effective as LARC for treating patients with low rectal cancer. Additional high-powered randomized trials are needed to determine whether LISR truly offers any advantages.

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What Is the Place of Intersphincteric Resection When Operating on Low Rectal Cancer?

ISRN Surgery ◽

10.5402/2012/585484 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Satoshi Nagayama ◽

Waheeb Al-Kubati ◽

Yoshiharu Sakai

Keyword(s):

Rectal Cancer ◽

Functional Outcomes ◽

Recent Literature ◽

Coloanal Anastomosis ◽

Preoperative Chemoradiotherapy ◽

Abdominoperineal Excision ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Rectal Cancers

Operating on low rectal cancer by performing an intersphincteric resection (ISR) with coloanal anastomosis has been adopted as an alternative to abdominoperineal excision (APE) following Schiessel et al. report in 1994, as it preserves the sphincter and avoids the need for a permanent stoma. We undertook a review of the recent literature specifically focusing on long-term oncologic and functional outcomes of ISR to evaluate whether this operation is a valid alternative to an APE. In conclusion, younger patients with T1 or T2 rectal cancers who require no preoperative therapy are ideal candidates for ISR, given that preoperative chemoradiotherapy may cause long-term severe anal dysfunction after ISR.

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Intersphincteric resection and hand-sewn coloanal anastomosis for low rectal cancer: Short-term outcomes in the Indian setting

Indian Journal of Gastroenterology ◽

10.1007/s12664-014-0522-7 ◽

2015 ◽

Vol 34 (1) ◽

pp. 23-28 ◽

Cited By ~ 5

Author(s):

Vishwas D. Pai ◽

Ashwin De Souza ◽

Prachi Patil ◽

Reena Engineer ◽

Supreeta Arya ◽

...

Keyword(s):

Rectal Cancer ◽

Coloanal Anastomosis ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Short Term ◽

Indian Setting

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Robotic versus Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Comparative Study of Short-term Outcomes

Journal of Minimally Invasive Surgery ◽

10.7602/jmis.2015.18.4.98 ◽

2015 ◽

Vol 18 (4) ◽

pp. 98-105 ◽

Cited By ~ 1

Author(s):

Jung Kyong Shin ◽

Yoonah Park ◽

Hee Cheol Kim ◽

Jung Wook Huh ◽

Yong Beom Cho ◽

...

Keyword(s):

Rectal Cancer ◽

Comparative Study ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Short Term ◽

Laparoscopic Intersphincteric Resection

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Intersphincteric Resection Is the Optimal Procedure for Very Low Rectal Cancer: Techniques, Morbidity, Oncologic and Functional Outcomes

Journal of Cancer Therapy ◽

10.4236/jct.2019.105033 ◽

2019 ◽

Vol 10 (05) ◽

pp. 400-410

Author(s):

Ali Zedan ◽

Anwar Tawfik ◽

Ebrahim Aboeleupn ◽

Asmaa Salah ◽

Aiat Morsy

Keyword(s):

Rectal Cancer ◽

Functional Outcomes ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Optimal Procedure ◽

Very Low Rectal Cancer

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Long Term Results of Modified Intersphincteric Resections for Low Rectal Cancer: A Single Center Experience

Medicina ◽

10.3390/medicina55120764 ◽

2019 ◽

Vol 55 (12) ◽

pp. 764

Author(s):

Vlad-Olimpiu Butiurca ◽

Călin Molnar ◽

Copotoiu Constantin ◽

Marian Botoncea ◽

Teodor Ioan Bud ◽

...

Keyword(s):

Rectal Cancer ◽

Functional Outcomes ◽

Low Rectal Cancer ◽

Long Term Results ◽

Preoperative Imaging ◽

Type Ii ◽

Rectal Tumors ◽

Modified Technique ◽

Wexner Score

Background and Objectives: The objective of this article is to evaluate the long-term oncological and functional outcomes following modified intersphincteric resections (ISR) for low rectal cancer. The modified technique consisted of the abandonment of colonic J-pouches, transverse coloplasty, or defunctioning temporary stoma in favor of a direct handsewn coloanal anastomosis (CAA). Material and Methods: Sixty consecutive patients with type II and III (juxta-anal or intra-anal) low rectal tumors underwent modified ISR by the same surgical team and were followed for a period of five years. Functional outcomes using the Wexner Score, postoperative complications, recurrence rates, morbidity, and mortality rates were assessed. Results: The five-year survival rate was 93.3% with a disease-free interval at three years of 98%. Morbidity was 15% (n = 9) consisting of intestinal wall necrosis (n = 6), stenosis (n = 2), and sacral metastasis (n = 1). The Wexner score values were, at 1 year, 8.5 (range, 4–13); at three years 7.2 (range, 2–11); and at 5 years 6.7 (range, 2–12). A second surgery was needed in only one case that showed postoperative transmural necrosis of the colonic wall. Conclusions: In highly selected patients with type II or III low rectal tumors and proper preoperative imaging staging, ISR might be a viable alternative to other techniques such as abdominoperineal resection and low anterior resection, both from a functional and an oncological perspective.

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