Outcomes of ultra-low anterior resection combined with or without intersphincteric resection in lower rectal cancer patients

Abstract

Compared with uLAR without ISR, the transabdominal ISR with levator-sphincter reinforcement provides a safe resection plane with competent CRM, concurrently reduces substantial complications, and marginally promotes recovery of neorectal function.

Outcomes of patients with abdominoperineal resection (APR) and low anterior resection (LAR) who had very low rectal cancer

“…However, advancements in surgical techniques such as ultra-low anterior resection and intersphincteric resection (ISR), enabled patients with low rectal cancer to undergo surgery without sacrificing the anal sphincter. [ 1 – 3 ]…”

“…When SSR is performed for very low rectal tumors that are close to the anal sphincter complex, the distal boundary of the resection is located in the anal canal. While small-scale studies have shown ISR to be generally safe, [ 3 , 11 , 12 ] the oncological safety profile of the resection of very low rectal tumors with ambiguous external anal sphincter involvement and uncertain circumferential resection margin (CRM) remains unclear. Moreover, the clinicopathological heterogeneity of patients renders it difficult to interpret the currently published data.…”

Risk calculators—methods, development, implementation, and validation

“…There is an ongoing intense activity in risk factor research regarding outcomes of visceral surgery which needs to be methodologically channeled and implemented in clinical decision making [30][31][32].…”

Assessments of Pudendal Motor and Sensory Nerves in Patients with or without Fecal Incontinence after Low Anterior Resection for Lower Rectal Cancer

“…Of these factors, sphincter dysfunction has been focused on as the main cause. The external anal sphincter (EAS), internal anal sphincter (IAS), and puborectalis muscle (PM) essentially establish continence [5] [7] [8]. Among these sphincter muscles, EAS is the most important to prevent FI [5] [7] [8].…”

“…The external anal sphincter (EAS), internal anal sphincter (IAS), and puborectalis muscle (PM) essentially establish continence [5] [7] [8]. Among these sphincter muscles, EAS is the most important to prevent FI [5] [7] [8]. Especially, voluntary contractions of EAS prevent FI that may be induced by an increase in abdominal pressure due to coughing or postural changes [7] [8].…”