Resultados a largo plazo de pacientes con adenocarcinoma de recto inferior tratados con resección anterior ultrabaja interesfintérica

Abstract

Introduction: Intersphinteric resection (ISR) allows preserve sphincter function in selected patients with rectal cancer (RC). Notwithstanding, it can produce alterations in defecation. Aim: To analyze the oncological and functional results after an ISR. Materials and Method: Observational, analytical, cross-sectional study, in the period 2007-2016. Inclusion criteria: Patients submitted to ISR by RC with curative intention. All the patients had a follow-up in 2017. Analysis of functional evaluation were performed by Jorge- Wexner, LARS and Kirwan scale. Statistical analysis: Descriptive statistics and Kaplan-Meier method. Results: Of 21 patients; Fourteen (67%) were male, average age: 59 years. Tumor location: 4 cm (2-6 cm) from anal verge. Eighteen (85.7%) patients received neoadjuvant therapy. All distal and radial margins were negative. One patient (4.8%) had distant metastases and there was no locoregional recurrence. With a median follow-up of 76.3 (9.8-126.8) months, the 5-year global and disease-free survival was: 100% and 95% (CI: 90.1-99.9%), respectively. With a median follow-up of 90 months (21.7-124.2); Functional evaluation was performed on 15/21 patients. The Jorge-Wexner score had a median of 13 (4-17) points, the LARS scale of 34 points and in Kirwan scale, four patients (26.7%) showed good function (Kirwan I-II). Conclusion: The oncological results of patients undergoing ISR are satisfactory, however, functional results should be taken into account when proposing this surgical procedure.