Abstract
In recent years, intersphincteric resection (ISR) has been increasingly used to replace abdominoperineal resection (APR) in the surgical treatment of ultra-low rectal cancer. This study was to compare the clinical efficacy of ISR and APR. Between 2012 and 2018, 74 consecutive patients with ultra-low rectal cancer underwent ISR or APR in our medical center. A retrospective comparison of these 2 procedures was performed. A total of 43 patients underwent ISR and 31 underwent APR were included in the study. No significant differences were found between 2 groups in gender, age, BMI, and ASA score. Intersphincteric resection group showed shorter operative time (P = .02) and less blood loss (P = .001). Hospital stays, time to soft diet, and postoperative 30-day complications were not significantly different between the 2 groups. R0 resection achieved 100% in both the groups. As for the long-term outcomes, the survival and recurrence rate were similar between 2 groups. Moreover, the LARS and Wexner score showed that the postoperative anal function after ISR were satisfactory. This study suggested that ISR was feasible and safe for selected patients with ultra-low rectal cancer, with clinically superior outcomes in select patients (small tumors/further from the anal verge) and similar oncological outcomes to APR, and the anal functional outcomes after ISR were acceptable.
Highlights
According to the global tumor statistical analysis, the incidence of colorectal cancer has increased year by year in recent years, in both sexes combined, the incidence rate of colorectal cancer ranks fourth, and the mortality rate ranks second
A total of 43 patients underwent intersphincteric resection (ISR) and 31 underwent abdominoperineal resection (APR) were included in the study
As for the long-term outcomes, the survival and recurrence rate were similar between two groups
Summary
A total of 43 patients underwent ISR and 31 underwent APR were included in the study. No significant differences were found between two groups in gender, age, BMI and ASA score. ISR group showed shorter operative time (P = 0.02) and less blood loss (P = 0.001). Time to soft diet, and postoperative thirty-day complications were not significantly different between the two groups. As for the long-term outcomes, the survival and recurrence rate were similar between two groups. LARS score and Wexner score showed the anal function after ISR was generally satisfactory
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