Abstract
Purpose: Intersphincteric resection is an alternative treatment method to abdominoperineal resection for low rectal cancer. The aim of this study is to review our limited experience about intersphincteric resection.
Material and Methods: The medical records of five patients treated for low rectal tumors by intersphincteric resection and coloanal anastomosis in our clinic between December 2006 and March 2009 were retrospectively reviewed.
Three of the five patients were female.The mean age of the patients was 61.2 years (45-72). All patients were treated with intersphincteric resection, coloanal anastomosis and diverting colostomy. Colostomy closure was performed in three patients. There were no mortalities or morbidities except temporary faecal incontinence. Defecatory function, which was evaluated by the number of bowel movements in a day and continence scores were at an acceptable ratio after three months from the operation.
Conclusion: With strictly marked rules, intersphincteric resection may be an eligible choice for sphincter-preserving surgery in low rectal cancer.
Keywords:
Rectum adenocarsinom, abdominoperineal resection, sphincter preserving surgery, intersphincteric resection
References
1Schiessel R, Novi G, Holzer B, Rosen HR, Renner K, Hölbling N et al. Technique and long-term results of intersphincteric resection for low rectal cancer, Dis Colon Rectum 2005;48:1858–1867.
2Renner, K, Rosen, HR, Novi, G, Hölbling, N, Schiessel, R. Quality of life after surgery for rectal cancer: do we still need a permanent colostomy. Dis Colon Rectum 1999;42:1160–1167.
3MacFarlane JK, Ryall RD, Heald RJ. Mesorectal excision for rectal cancer Lancet 1993;341: 457-460.
4Schiessel R, Karner HJ, Herbst F et al. İntersphincteric resection for low rectal tumors. Br J Surg 1994;81:1376–1378.
5Bretagnol F, Rullier E, Laurent C, et al. Comparison of functional results and quality of life between intersphincteric resection and conventional coloanal anastomosis for low rectal cancer. Dis Colon Rectum 2004;47:832–838.
6Gamagami R, Istvan G, Cabarrot P, et al. Fecal continence following partial resection of the anal canal in distal rectal cancer: long-term results after coloanal anastomoses. Surgery 2000;127:291–295.
7Bittorf B, Stadelmaier U, Gohl J, et al. Functional outcome after intersphincteric resection of the rectum with coloanal anastomosis in low rectal cancer. Eur J Surg Oncol. 2004;30:260–265.
8Rullier E, Zerbib F, Laurent C, et al. Intersphincteric resection with excision of internal anal sphincter for conservative treatment of very low rectal cancer. Dis Colon Rectum. 1999;42:1168–1175.
9Holzer B, Urban M, Hölbling N et al. Magnetic resonance imaging predicts sphincter invasion of low rectal cancer and influences selection of operation. Surgery 2003;133: 656-661.
10Blomqvist L, Rubio C, Holm T, Machado M, Hindmarsh T. Rectal adenocarcinoma: assessment of tumour involvement of the lateral resection margin by MRI of resected specimen Br J Radiol 1993:72;18-23.
11Cassidy J, Tabernero J, Twelves C, Brunet R, Butts C, Conroy T et al. XELOX (Capecitabine plus Oxaliplatin): Active first-line therapy for patients with metastatic colorectal cancer, Journal of Clinical Oncology 22;2004:2084-2091.
12Fürst A, Stuttner S, Agha A, Beham A, Jauch K. Colonic J-pouch vs. coloplasty following resection of distal rectal cancer Dis Colon Rectum 2003:46;1161-1166.
13Bittorf B, Stadelmaier U, Göhl J, Hohenberger W, Matzel KE. Functional outcome after intersphincteric resection of the rectum with coloanal anastomosis in low rectal cancer Eur J Surg Onc 2004:30; 260-265.
