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Open AccessArticle

Long Term Results of Modified Intersphincteric Resections for Low Rectal Cancer: A Single Center Experience

1
First Department of Surgery, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, 540139 Târgu-Mureș, Romania
2
Clinic of Vascular Surgery, Emergency County Hospital, 540139 Târgu-Mureș, Romania
3
Department of Pathology, Emergency County Hospital, 540136 Târgu-Mureș, Romania
4
Department of Pathology, University of Medicine, Pharmacy, Science and Technology, 540139 Târgu-Mureș, Romania
*
Author to whom correspondence should be addressed.
Authors contributed equally to this work.
Medicina 2019, 55(12), 764; https://doi.org/10.3390/medicina55120764
Received: 29 September 2019 / Revised: 25 November 2019 / Accepted: 27 November 2019 / Published: 29 November 2019
Background and Objectives: The objective of this article is to evaluate the long-term oncological and functional outcomes following modified intersphincteric resections (ISR) for low rectal cancer. The modified technique consisted of the abandonment of colonic J-pouches, transverse coloplasty, or defunctioning temporary stoma in favor of a direct handsewn coloanal anastomosis (CAA). Material and Methods: Sixty consecutive patients with type II and III (juxta-anal or intra-anal) low rectal tumors underwent modified ISR by the same surgical team and were followed for a period of five years. Functional outcomes using the Wexner Score, postoperative complications, recurrence rates, morbidity, and mortality rates were assessed. Results: The five-year survival rate was 93.3% with a disease-free interval at three years of 98%. Morbidity was 15% (n = 9) consisting of intestinal wall necrosis (n = 6), stenosis (n = 2), and sacral metastasis (n = 1). The Wexner score values were, at 1 year, 8.5 (range, 4–13); at three years 7.2 (range, 2–11); and at 5 years 6.7 (range, 2–12). A second surgery was needed in only one case that showed postoperative transmural necrosis of the colonic wall. Conclusions: In highly selected patients with type II or III low rectal tumors and proper preoperative imaging staging, ISR might be a viable alternative to other techniques such as abdominoperineal resection and low anterior resection, both from a functional and an oncological perspective. View Full-Text
Keywords: intersphincteric resection; low rectal cancer; Wexner score; survival; functional outcome intersphincteric resection; low rectal cancer; Wexner score; survival; functional outcome
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Butiurca, V.-O.; Molnar, C.; Constantin, C.; Botoncea, M.; Bud, T.I.; Kovacs, Z.; Satala, C.; Gurzu, S. Long Term Results of Modified Intersphincteric Resections for Low Rectal Cancer: A Single Center Experience. Medicina 2019, 55, 764.

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