Total anorectal reconstruction supported by electrostimulation gracilis neosphincter.

Abstract

To review and to update the results of Total Anorectal Reconstruction with Electrostimulated Graciloplasty (ES-TAR) at the same time as or following abdominoperineal resection (APR). A university hospital in Italy. Retrospective study. A series of 98 consecutive anorectal cancer patients who had undergone ES-TAR (in 88 cases at the same time as APR; in 10 cases following APR), 61 of whom are still evaluable in respect of continence (median follow-up period 55 months). There was no mortality. Thirty-seven percent of patients had postoperative complications with no impact on survival or functional outcome. The 5-year survival rate in 50 patients was 61% and the 5-year estimated cumulative probability of survival in 81 patients was 65%. Local recurrence rate was 16%. Continence was achieved in 87% of patients with a chronically stimulated TAR, and in 69% of patients with short-term stimulation. ES-TAR is a safe and effective method for both curing anorectal cancer and restoring continence. It may be considered a reliable alternative to sphincter-saving procedures in lower rectal cancer patients.