title: Feasibility of laparoscopic intersphincteric resection for patients with cT1-T2 low rectal cancer.
abstract: OBJECTIVE
  The purpose of this study was to assess the feasibility of laparoscopic intersphincteric resection (LAP-ISR) for rectal cancer in terms of morbidity, oncological outcomes, and functional results.
  
  
  METHODS
  Thirty-seven patients with primary low rectal cancer cT1-T2 underwent LAP-ISR. Surgical outcomes, pathological results, postoperative complications, oncological outcomes, and functional results were analyzed retrospectively.
  
  
  RESULTS
  Three patients (8.1%) had carcinoma in situ, 22 (59.5%) had pT1 tumor, and 11 (29.7%) had pT2 tumor. Eleven patients (29.7%) were diagnosed as being node positive, while 26 (70.3%) had node-negative disease. The median operative time was 315 min (range: 195-502). The median blood loss was 37 ml (range: 0-745). One case was converted to open surgery. Pathological complete resection was achieved in all cases. There was no surgical mortality. Postoperative complications of grade III-IV on the Clavien-Dindo classification were observed in 16.2% of the patients. The median follow-up period was 2.8 years (range: 187-2,241 days), and 3-year disease-free survival was 93.1%. No patient developed local recurrence. The functional result was objectively good.
  
  
  CONCLUSIONS
  LAP-ISR can be recommended as a feasible, ultimate sphincter-preserving procedure with acceptable functional and intermediate-term oncological outcomes in patients with cT1-T2 very low rectal cancer.
authors: Division of Colorectal Surgery, Shizuoka Cancer Center Hospital, Nagaizumi-cho, Japan.
authors: Akio
authors: A
authors: Shiomi
authors: Yusuke
authors: Y
authors: Kinugasa
authors: Tomohiro
authors: T
authors: Yamaguchi
authors: Syunsuke
authors: S
authors: Tsukamoto
authors: Hiroyuki
authors: H
authors: Tomioka
authors: Hiroyasu
authors: H
authors: Kagawa
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D057868:Anastomotic Leak / Q000209:etiology; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome