Functional outcome after intersphincteric resection of the rectum with coloanal anastomosis in low rectal cancer

Bittorf, B.; Stadelmaier, U.; Göhl, J.; Hohenberger, Werner; Matzel, Klaus E.

doi:10.1016/j.ejso.2003.11.011

Cited by 90 publications

(60 citation statements)

References 20 publications

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“…Additionally, postoperative quality of life after surgery for rectal cancer appears to be at least similar to that of the average population of the same age [16,43]. This is amazing if one considers the fact that, particularly, surgery in distal rectal cancer, resulting in a low or even colo-anal anastomosis, often leads to deterioration of sphincter function, with faecal incontinence [44][45][46][47][48][49]. Obviously, the impaired functional outcome does not necessarily result in a worse level of global quality of life.…”

Section: Quality Of Life After Rectal Cancer Surgerymentioning

confidence: 94%

Survival after surgical treatment of cancer of the rectum

Hohenberger

Bittorf

Papadopoulos

et al. 2004

Langenbecks Arch Surg

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Tumour-related prognostic factors have the greatest influence on clinical decisions with regard to choice of a therapeutic concept. The increasing survival rates after treatment of rectal carcinoma have led to a focus on postoperative quality of life. Postoperative long-term global quality of life is similar to the preoperative level. Oncological outcome is still the most important factor, and tumour recurrence leads to a strong impairment of quality of life.

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Section: Quality Of Life After Rectal Cancer Surgerymentioning

confidence: 94%

Survival after surgical treatment of cancer of the rectum

Hohenberger

Bittorf

Papadopoulos

et al. 2004

Langenbecks Arch Surg

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“…Sigmas von der seitlichen Beckenwand und Darstellung der mesorektalen Faszie (1) und des linken N. hypogastricus (2) Abb. 2 …”

Section: Blick Von Links Nach Ablösen Desunclassified

“…Aus onkologischen Gründen ist eine eventu elle Exstirpation ohnehin nur für das un tere Drittel zu diskutieren. Hierbei kann mit der abdominoperanalen intersphink tären Resektion [10] mit nahezu vollstän diger Entfernung des M. sphincter ani in ternus bei noch etwa einem weiteren Drit tel der Patienten doch noch der Sphink ter erhalten werden, auch wenn etwa ein Fünftel in nicht vorhersagbarer Weise spä ter mit der Sphinkter wie aber auch der Darmfunktion nicht zufrieden ist [1].…”

Section: Operationsverfahrenunclassified

Offene Rektumchirurgie

Hohenberger

2007

Chirurg

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This article describes the individual techniques and strategies of conventional surgery of the rectum, including photographic documentation of the important steps. Our own figures of postoperative complications and long-term oncological results obtained by this approach are added. In our experience, operations for radical surgery of rectal cancer have been the most frequent procedures. In the pelvis, the important planes between which dissection occurs are (1) the mesorectal fascia up to the origin of the inferior mesenteric artery and continuing laterally to the mesosigmoid fascia and (2) on the opposite side the autonomous nerves forming the plexus and web-like layers. Apart from rectal excision, complete mobilisation of the descending colon and the splenic flecture is a prerequisite for tension-free anastomoses and low leakage rates. Again this dissection follows the plane between the mesocolon and the parietal fascia covering the retroperitoneal organs. The greater omentum has to be taken down from the transverse colon with exposure of the entire lesser sac, followed by the division of the transverse mesocolon along the inferior aspect of the pancreas, including central tying of the inferior mesenteric vein.

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“…After closing the rectum with a pursestring suture on the margin of the mucos and internal sphincter to avoid contamination, the actual dissection is performed in the intersphincteric plane to the level of the dissection in the pelvis. The intersphincteric resection is usually associated with poorer continence performance than LAR with colorectal anastomosis (9,12, 13,14,53). In addition to the loss of the cloacogenic segment and the transitional zone with its sensory function, including the hemorrhoids with their contribution to continence, more frequent incontinence is due to the partial loss of the internal sphincter and to the greater stretching trauma involved in peranal access compared with stapler anastomosis.…”

Section: Continence Disorders Following Intersphincteric Resection (Isr)mentioning

confidence: 99%

Causes and Prevention of Functional Disturbances Following Low Anterior Resection for Rectal Cancer

Gross¹

2011

Rectal Cancer - A Multidisciplinary Approach to Management

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Functional outcome after intersphincteric resection of the rectum with coloanal anastomosis in low rectal cancer

Cited by 90 publications

References 20 publications

Survival after surgical treatment of cancer of the rectum

Survival after surgical treatment of cancer of the rectum

Offene Rektumchirurgie

Causes and Prevention of Functional Disturbances Following Low Anterior Resection for Rectal Cancer

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