[Efficacy evaluation of intersphincteric resection during anus-preserving operation for ultralow rectal carcinoma].
OBJECTIVE
To evaluate anorectal dynamics, function and efficacy of ultralow rectal carcinoma patients undergone intersphincteric resection(ISR).


METHODS
From January 2004 to August 2007, 30 patients with ultralow rectal carcinoma(2.5-4.0 cm distance from anal edge) underwent ISR. All the patients received anorectal manometry before and after operation. The postoperative anal function was evaluated by Williams continence standard and the treatment outcome was followed up.


RESULTS
After ISR operation, anal resting pressure, maximum squeeze pressure and maximum tolerance volume of the rectum decreased significantly (all P<0.01) and restored gradually, but not to normal. The rectal anal inhibitory reflex disappeared in 27 patients(90.0%) and was not improved. According to Williams continence standard, 86.7%, 93.3% and 96.7% of patients obtained acceptable anal function in 3, 6, and 12 months after operation respectively. During follow-up of 12 to 44 months, all the patients were still alive and no patient developed pelvis or local recurrence, distant metastasis and anastomotic leakage. Fecal eczema of anus occurred in 10 patients, colonic mucosa prolapse in 2 patients and stenosis of anal canal in one patient.


CONCLUSIONS
ISR for ultralow rectal carcinoma can not only attain radical treatment outcome, but also preserve anal sphincter.
Zhuang
Chao-ping
CP
Department of General Surgery, Shantou University Medical College, Guangdong Shantou 515041, China. st-tp@163.com
Cai
Gao-yang
GY
Li
Ting-han
TH
Wang
Yong-quan
YQ
Chen
Wei-rong
WR
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods*; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D016896:Treatment Outcome