Functional results of intersphincteric resection for low rectal cancer

Abstract

These functional results suggest that ISR should be considered as an alternative to abdominoperineal resection for low rectal cancer. However, as the outcome for continence is worse after total ISR than subtotal or partial ISR, the indication for total ISR should strictly take into account the preoperative sphincter function.

Levator–sphincter reinforcement after ultralow anterior resection in patients with low rectal cancer: the surgical method and evaluation of anorectal physiology

“…In the current study, the MRP and MSP were lower postoperatively, and did not recover to the preoperative levels until 12 months postoperatively, similar to another study [13]. Both the UDV and MTV, representing the sampling reflex and rectal capacity, respectively, were increased at 12 months postoperatively, consistent with another report [14].…”

“…The correlation between the postoperative RAIR recovery and anorectal function has yet to be consistently demonstrated. Fecal continence is maintained by a complex process that requires normal anorectal sensation, intact sphincter and levator function, good reservoir function of the distal rectum or neorectum, and the motivation to maintain continence [13].The incontinence scoring system designed by Jorge and Wexner (scale: perfect, 0; complete incontinence, 20) and used in the current study has been validated as an efficient method of assessing various components of incontinence [6]. In the current study the mean incontinence score was 4.4 at 24 months postoperatively.…”

Safety and feasibility of laparoscopic intersphincteric resection for a lower rectal tumor

“…Recently, 3-dimensional vector manometry (3D manometry) has been used to determine the median of the maximum resting pressure and maximum squeeze pressure in the anal sphincter (14). The current study also examined postoperative sphincter status using manometry in patients who underwent ISR and ultra-low anterior resection (ULAR) to clarify specific findings associated with these two surgical procedures.…”

Chirurgie des kolorektalen Karzinoms

“…In einer prospektiv-randomisierten monozentrischen Studie aus Taipei, Taiwan, wurde nach laparoskopischer TME der Kolon-J-Pouch (8 cm lang; n = 24) mit der einfachen geraden kolorektalen Anastomose (n = 24) verglichen [34] Anmerkung: Die intersphinktäre Resektion kann man in drei Grade einteilen: über der Linea dentata, in Höhe der Linea dentata und an der anokutanen Grenze. Die Funktion verschlechtert sich mit der Tiefe der Resektion, allerdings gibt es keine klinisch relevanten präthe-rapeutischen Entscheidungskriterien für die spätere Funktion [55].…”