title: Long-term results of intersphincteric resection for low rectal cancer.
abstract: OBJECTIVE
  Intersphincteric resection has been performed as an alternative to abdominoperineal resection for low rectal cancer. The purpose of this study was to assess the long-term results after intersphincteric resection in terms of the morbidity, oncologic safety, and defecatory function.
  
  
  METHODS
  Between 1994 and 2006, 107 consecutive patients with low rectal cancer had curative intersphincteric resection, categorized as total, subtotal, or partial resection of the internal anal sphincter.
  
  
  RESULTS
  There were no mortalities. Neorectal mucosal prolapse in patients with total intersphincteric resection and coloanal anastomotic stenosis in patients with subtotal or partial intersphincteric resection were observed as characteristic late complications. The five-year disease-free survival rates classified according to the TNM stage were 100 percent for stage I, 83.5 percent for stage II, and 72.0 percent for stage III cases. The five-year cumulative local recurrence rate after intersphincteric resection was 2.5 percent. Defecatory function, which was evaluated by bowel movement in a 24-hour period, and continence after intersphincteric resection were objectively good. The results of the multivariate analysis revealed that age was the only factor associated with a risk of fecal incontinence.
  
  
  CONCLUSIONS
  Provided strict selection criteria are used, intersphincteric resection may be the optimal sphincter-preserving surgery for low rectal cancer.
authors: Coloproctology Center, Takano Hospital, Kumamoto, Japan. k-yamada@magma.jp
authors: Kazutaka
authors: K
authors: Yamada
authors: Shunji
authors: S
authors: Ogata
authors: Yasumitsu
authors: Y
authors: Saiki
authors: Mitsuko
authors: M
authors: Fukunaga
authors: Yoriyuki
authors: Y
authors: Tsuji
authors: Masahiro
authors: M
authors: Takano
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000704:Analysis of Variance; D003672:Defecation / Q000502:physiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011183:Postoperative Complications; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome