Short-Term Assessment of Intersphincteric Resection in Low Rectal Cancer

Abstract
Background: Correlation analysis between functional outcomes and different factors (pouch, stoma, ISR type, age and sex) revealed: Pouch formation and type of ISR had significant correlations with some functional aspects.
Aim of the Study: To evaluate the oncologic safety and functional outcomes of Intersphincteric Resection (ISR) as an alternative to Abdominoperineal Resection (APR) in low rectal cancer.
Patients and Methods: Patients presenting to the National Cancer Institute, Cairo University from May 2014 to October 2014; with locally advanced low (3-6m from the anal verge) rectal cancer and ended their long-course neoadjuvant chem-oradiotherapy were subjected to ISR if eligible. These patients were assessed and followed for the short-term outcomes of ISR.
Results: Twenty one patients underwent ISR. There was no mortality. Ten patients had postoperative complications.
All cases had free distal margin and one patient had +ve radial margin. The Improvement of all functional aspects occurred with time. Kirwan's grade of continence by the 15th month was: I: 5/16 (31.3%), II: 8 (50%) and III: 3 (18.8%). This is very clear comparing it with 3rd month results: II: 3/19 (15.8%), III: 13 (68.4%) and IV: 3 (15.8%).
Conclusion: Intersphincteric resection is an oncologically safe alternative to the standard APR in low rectal cancer, with the added benefit of improving the quality of life by avoiding a permenant stoma, together with acceptable functional out-comes.