Long-Term Results of Intersphincteric Resection for Low Rectal Cancer

Yamada, Kazutaka; Ogata, Shunichiro; Saiki, Yasumitsu; Fukunaga, Mitsuko; Tsuji, Y.; Takano, Masahiro

doi:10.1007/dcr.0b013e31819f5fa2

Cited by 99 publications

(64 citation statements)

References 37 publications

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“…In contrast, multivariate analysis in Yamada et al [32] 's study disclosed patient's age at surgery as the only risk factor for postoperative fecal incontinence.…”

Section: Wjgo|wwwwjgnetcommentioning

confidence: 86%

“…Laparoscopic, open [30] and robotic [31] approaches have been used for the abdominal phase. For the perineal phase, the patient is placed in the high lithotomy position, a self-retaining retractor is applied for perineal exposure [28] and 1 mg epinephrine diluted in 20 mL of saline solution is injected at several points beneath the anal mucosa, for minimization of bleeding and facilitation of intersphincteric dissection [32] . A circumferential incision in the anal mucosa, at a distance of at least 1 cm from the macroscopic distal edge of the tumor for T1 lesions and 2 cm for T2-3 lesions is made in such a way, to include in the specimen the whole rectal wall as well as a part or the whole of the IAS [32] (Figure 1).…”

Section: Surgical Techniquementioning

confidence: 99%

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Low rectal cancer: Sphincter preserving techniques-selection of patients, techniques and outcomes

Dimitriou

Michail

Moris

et al. 2015

WJGO

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Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal PlanE for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic MicroSurgery (TEM) and TransAnal Minimally Invasive Surgery (TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery. Core tip: The present review presents the most recent advances in the field of sphincter preserving surgery for the treatment of low rectal cancer patients, providing indications, patients' selection, surgical techniques, multimodality approaches, postoperative course and oncological and functional outcomes. In particular, the review focuses on data deriving from prospective EDITORIAL

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“…In contrast, multivariate analysis in Yamada et al [32] 's study disclosed patient's age at surgery as the only risk factor for postoperative fecal incontinence.…”

Section: Wjgo|wwwwjgnetcommentioning

confidence: 86%

Section: Surgical Techniquementioning

confidence: 99%

Low rectal cancer: Sphincter preserving techniques-selection of patients, techniques and outcomes

Dimitriou

Michail

Moris

et al. 2015

WJGO

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“…There are several examinations that can be performed for anorectal function, such as the clinical score, manometry, defecography, and electromyography. 6,[21][22][23] However, it is difficult to conclude whether these examinations provide accurate results. Defecation is the sum of the functions of all mechanisms of anorectal evacuation.…”

Section: Discussionmentioning

confidence: 99%

Fecoflowmetric Analysis of Anorectal Motor Function in Postoperative Anal-Preserving Surgery Patients With Low Rectal Cancer Comparison With the Wexner Score and Anorectal Manometry

Ryu

Akagi

Yagi

et al. 2015

International Surgery

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The aim of this study was to elucidate whether fecoflowmetry (FFM) could evaluate more detailed evacuative function than anorectal manometry by comparing between FFM or anorectal manometric findings and the clinical questionnaires and the types of surgical procedure in the patients who received anal-preserving surgery. Fifty-three patients who underwent anal-preserving surgery for low rectal cancer were enrolled. The relationships between FFM or the manometric findings and the clinical questionnaires and the types of procedure of anal-preserving surgery were evaluated. There were significant differences between FFM markers and the clinical questionnaire and the types of the surgical procedure, whereas no significant relationship was observed between the manometric findings and the clinical questionnaire and the types of the surgical procedure. FFM might be feasible and useful for the objective assessment of evacuative function and may be superior to manometry for patients undergoing anal-preserving surgery.

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“…[21] после выполнения ин-терсфинктерных резекций у пациентов при ранних стадиях забо-левания Т(1-2)N(0-1). Пятилетняя выживаемость составила 97%, безрецидивная -86%, местный рецидив -2,5%.…”

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Treatment for cancer of the lower rectal ampulla. State-of-the-art

Черниченко¹,

Сидоров²,

Boiko³

2015

Onkol. Z. im. P.A. Gercena

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Long-Term Results of Intersphincteric Resection for Low Rectal Cancer

Abstract: Provided strict selection criteria are used, intersphincteric resection may be the optimal sphincter-preserving surgery for low rectal cancer.

Cited by 99 publications

References 37 publications

Low rectal cancer: Sphincter preserving techniques-selection of patients, techniques and outcomes

Low rectal cancer: Sphincter preserving techniques-selection of patients, techniques and outcomes

Fecoflowmetric Analysis of Anorectal Motor Function in Postoperative Anal-Preserving Surgery Patients With Low Rectal Cancer Comparison With the Wexner Score and Anorectal Manometry

Treatment for cancer of the lower rectal ampulla. State-of-the-art

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