Function after intersphincteric resection for low rectal cancer and its influence on quality of life

Barišić, G; Markovic, Velimir; Popović, Miloš A.; Dimitrijević, Ivan; Gavrilovic, P.; Krivokapić, Zoran

doi:10.1111/j.1463-1318.2010.02244.x

Cited by 60 publications

(43 citation statements)

References 24 publications

(28 reference statements)

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“…Available data were summarized from 14 articles 16, 18, 21, 22, 23, 24, 25, 26, 30, 31, 33, 45, 46, 47…”

Section: Resultsmentioning

confidence: 99%

“…QoL such as physical, social and psychological aspects of a patient's life is likely to be affected by anal dysfunction 28, 79. QoL outcomes of ISR patients were relatively good based on the SF‐36, EORTC QLQ‐C30, and FIQL scales 20, 46, 48. However, further studies are required to evaluate the QoL.…”

Section: Discussionmentioning

confidence: 99%

“…However, some studies including conventional Parks’ CAA, or low anterior resection with stapled anastomosis have caused misunderstanding of ISR. Moreover, quality of life (QoL) impairment caused by fecal incontinence remains unclear 20, 46, 48, 54, 55, 56. The present review investigates and discusses the surgical, oncological and functional outcomes, as well as QoL, of ISR.…”

Section: Introductionmentioning

confidence: 98%

“…ISR is the ultimate anal preservation surgery by both abdominal and anal approaches which consists of TME and excision of the internal anal sphincter. The surgical technique changed the concept of anal preservation and, since 2000, has rapidly expanded not only in Europe, but also in Japan and other Asian countries 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53. Also, laparoscopic‐ISR has come to be aggressively carried out 38, 39, 40, 41, 42.…”

Section: Introductionmentioning

confidence: 99%

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Intersphincteric resection for very low rectal cancer: A review of the updated literature

Shirouzu

Murakami

Akagi

2017

Annals of Gastroent Surgery

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Intersphincteric resection (ISR) has rapidly increased worldwide including laparoscopic surgery. However, there are some concerns for the definition of ISR, surgical technique, oncological outcome, anal function, and quality of life (QoL). The aim of the present study is to evaluate those issues. A review of this surgical technique was carried out by searching English language literature of the PubMed online database and appropriate articles were identified. With regard to open‐ISR, the morbidity rate ranged from 7.5% to 38.3%, with lower mortality rates. Local recurrence rates varied widely from 0% to 22.7%, with a mean follow‐up duration of 40–94 months. Disease‐free and overall 5‐year survival rates were 68–86% and 76–97%, respectively. Those outcomes were equivalent to laparoscopic‐ISR. Surgical and oncological outcomes of ISR were generally acceptable. However, accurate evaluation of anal function and QoL was difficult because of a lack of standard assessment of various patient‐related factors. The surgical and oncological outcomes after ISR seem to be acceptable. The ISR technique seems to be valid as an alternative to abdominoperineal resection in selected patients with a very low rectal cancer. However, both necessity for ISR and expectations of QoL impairment as a result of functional disorder should be fully discussed with patients before surgery.

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“…Available data were summarized from 14 articles 16, 18, 21, 22, 23, 24, 25, 26, 30, 31, 33, 45, 46, 47…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Shirouzu

Murakami

Akagi

2017

Annals of Gastroent Surgery

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“…Partial or total resection of the internal sphincter muscle resulted in defecatory dysfunction with frequent defecation, urgency, and fecal incontinence [16,18,29]. Moreover, preoperative radiotherapy against T3 tumors or lymph node involvement was found to have a negative impact on anal function after ISR [17,18,26].…”

Section: Surgical Proceduresmentioning

confidence: 99%

Analysis of Clinical Factors Associated with Anal Function after Intersphincteric Resection for Very Low Rectal Cancer

Ito

Saitô

Sugito

et al. 2009

Diseases of the Colon &Amp; Rectum

135

104

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Background: Intersphincteric resection (ISR) has been used to avoid permanent colostomy in very low rectal cancer patients. This study aimed to assess the surgical safety and oncologic and functional outcomes of ISR. Methods: The records of 30 consecutive very low rectal cancer patients who underwent ISR without neoadjuvant therapy were retrospectively analyzed; survival and locoregional recurrence rates were calculated by the Kaplan-Meier method. Incontinence was assessed by a functionality questionnaire and the Wexner score. Results: The median distance between the distal margin of the dentate line was 10 mm. A total of 12, 4, and 14 patients underwent partial ISR, subtotal ISR, and total ISR, respectively. The mean distal resection margin was negative in all cases, and circumferential resection margin was positive in two cases. Morbidity was 33.3%: anastomotic stricture in seven patients, colonic J-pouch prolapse in two patients, and an anovaginal fistula in one patient. During the median, 56.2-month follow-up period, local, distant, and combined recurrences occurred in four, three, and two patients, respectively. The 5-year overall and disease-free survival rates were 76.5% and 68.4%, respectively. Local recurrence rates were 5.2% for the patients with Tis-T2 tumors as compared with 45.5% for those with T3 tumors (P = 0.008). The mean Wexner scores and stool frequencies, 12 months after stoma closure in 19 patients, were 11.5 and 6.6 per 24 h, respectively. Significant differences were not seen in the Wexner scores between partial ISR and subtotal/total ISR (11.8 ± 2.6 and 9.1 ± 5.6). Stool frequency (P = 0.02), urgency (P = 0.04), and fragmentation (P = 0.015) were worse in patients with anastomotic stricture than in those without; there was no symptom improvement in patients with anastomotic stricture. Conclusions: The anastomotic strictures in patients undergoing ISR may have negatively affected anal function. For total ISR patients, at least, informed consent stating the possibility of a permanent colostomy is necessary.

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Systematic review of outcomes after intersphincteric resection for low rectal cancer

Martin

Heneghan

Winter

2012

British Journal of Surgery

201

145

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Function after intersphincteric resection for low rectal cancer and its influence on quality of life

Abstract: Although ISR does not affect quality of life in general, the extent of internal anal sphincter resection has a negative impact on symptom-specific quality of life owing to faecal incontinence.

Cited by 60 publications

References 24 publications

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Analysis of Clinical Factors Associated with Anal Function after Intersphincteric Resection for Very Low Rectal Cancer

Systematic review of outcomes after intersphincteric resection for low rectal cancer

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