Use of Smooth Muscle Plasty After Intersphincteric Rectal Resection to Replace a Partially Resected Internal Anal Sphincter: Long-Term Follow-Up

Krand, Osman; Yaltı, Tunç; Tellioglu, Gurkan; Kara, Muammer; Berber, İbrahim; Titiz, M.I.

doi:10.1007/dcr.0b013e3181b55507

Cited by 24 publications

(16 citation statements)

References 25 publications

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“…Available data were extracted from 22 articles21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42 and are summarized in Table 1. The most common indication for ISR is a tumor with T1–3 categories and a tumor located at 10–50 mm from the anal verge.…”

Section: Resultsmentioning

confidence: 99%

“…After the rectum is completely separated from the anal canal structures, the specimen is taken out of the anus. Thereafter, hand‐sewn CAA is done using straight colon,21, 23, 33 J‐pouch,26, 28 coloplasty30 or C‐pouch 22. Smooth muscle plasty was devised as a neo‐sphincter to improve anal function 22, 30.…”

Section: Resultsmentioning

confidence: 99%

“…Thereafter, hand‐sewn CAA is done using straight colon,21, 23, 33 J‐pouch,26, 28 coloplasty30 or C‐pouch 22. Smooth muscle plasty was devised as a neo‐sphincter to improve anal function 22, 30. Combined EAS resection (ESR) is sometimes carried out for tumors with suspected invasion into the intersphincteric space and/or EAS 17, 44, 53.…”

Section: Resultsmentioning

confidence: 99%

“…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%

“…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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