Experience in use of intersphincteric resection during anus-preserving operation for very low rectal cancer
- VernacularTitle:括约肌间切除术在超低位直肠癌保肛手术中的应用
- Author:
Hong ZHANG
;
Chunsheng CHEN
;
Jinchun CONG
;
Lei QIAO
;
Yong FENG
;
Enqing LIU
- Publication Type:Journal Article
- Keywords:
Rectal Neoplasm/surg;
Intersphincteric Resection;
Anal function
- From:
Chinese Journal of General Surgery
2001;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the results of anal function and oncologic effect of intersphincteric resection(ISR) for very low rectal cancer Methods Sixteen patients who had ISR from March 1999 to March 2006 in our hosptal.After complete dissection of the rectum and mesorectum down to the pelvic floor,the internal sphincter was separated from the external sphincter and puborectalis and resected together with the rectum,then the coloanal anastomosis was performed.On postoperative day 7,the anal contraction function training was started;on week 4,biofeedback training was started;on week 2,chemotherapy was used for Dukes B,C stage,and on week 4 radiotherapy was used.Results There was no operative mortality,and no anastomotic leakage.Colonic mucosa prolapse developed in two patients,two developed late strictures of the coloanal anastomosis and one had wound problem.At follow-up of 3 months to 7 years,there were 2 deaths from liver metastasis and 1 death from lung metastasis;no patient developed local recurrence.According to Williams continence status level,acceptable postoperative anal function were obtained in 62.5 %,80.0 %,and 84.6 % of patients at 3,6,and 12 months respectively.Conclusions ISR is safe for selected patients with very low rectal tumor,operative morbidity is low,and the curability rate and anal functional results are satisfactory.
