title: Oncological and functional outcomes of intersphincteric resection for low rectal cancer.
abstract: BACKGROUND
  The intersphincteric resection technique has been used to extend the opportunity for sphincter preservation in patients with very low rectal cancer. The aim of this study is to assess the long-term oncological and functional outcomes of intersphincteric resection.
  
  
  METHODS
  Patients with extraperitoneal rectal cancer were treated and retrospectively chart reviewed. The oncological and functional outcomes were evaluated. Comparisons of the overall disease-free survival and recurrence were analyzed for the different surgical procedures.
  
  
  RESULTS
  From July 2002 to August 2009, 162 patients with extraperitoneal rectal cancer were retrospectively chart reviewed. One-hundred one patients (62.3%) underwent low anterior resection, 26 patients (16%) received radical proctectomy and intersphincteric resection with coloanal anastomosis, and 23 (14.2%) had abdominoperineal resection. The sphincter preservation rate was 80%. In the intersphincteric resection group, overall survival rates at 3 and 5 y were 83% and 83%, and disease-free survival at 3 and 5 y were 82% and 76%, respectively. The mean stool frequency was 4.7 per 24 h. There were 38.1% of patients suffering from stool fragmentation, and 23.8% had nocturnal defecation. About one-third of the patients required antidiarrheal medications. Overall, 90.8% of patients were satisfied with the functional results of surgery.
  
  
  CONCLUSIONS
  Our data show intersphincteric resection for low rectal cancer is feasible and safe. Preoperative radiotherapy may negatively affect symptom-specific quality of life.
authors.affiliation: Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Kuo
authors.forename: Chin-Sheng
authors.initials: CS
authors.lastname: Hung
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Wu
authors.forename: Web
authors.initials: W
authors.lastname: Wang
authors.forename: Ka-Wai
authors.initials: KW
authors.lastname: Tam
authors.forename: Hung-Hua
authors.initials: HH
authors.lastname: Liang
authors.forename: Yu-Jia
authors.initials: YJ
authors.lastname: Chang
authors.forename: Po-Li
authors.initials: PL
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003672:Defecation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome