Intersphincteric resection for low rectal cancer: laparoscopic vs open surgery approach

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Sphincter-saving surgery for rectal cancer is established, but less so for lower third tumors.
• Laparoscopic techniques offer potential benefits in recovery and outcomes.

Purpose of the Study:

• To evaluate the feasibility and efficacy of laparoscopic intersphincteric resection for low rectal cancer.
• To compare outcomes of laparoscopic versus open intersphincteric resection.

Main Methods:

• Retrospective comparative study of 175 patients undergoing open or laparoscopic intersphincteric resection for rectal tumors below 6 cm from the anal verge.
• Included total mesorectal excision with internal sphincter excision and coloanal anastomosis.
• Analyzed recurrence, survival (Kaplan-Meier), and functional outcomes (Wexner score).

Main Results:

• No significant differences in postoperative mortality or morbidity between laparoscopic and open groups.
• Similar 5-year local recurrence rates (5% vs. 2%) and disease-free survival (70% vs. 71%).
• Comparable functional and continence scores between the two surgical approaches.

Conclusions:

• Intersphincteric resection does not compromise long-term tumor control for low rectal cancer.
• Laparoscopic intersphincteric resection demonstrates comparable safety and efficacy to open surgery with similar short- and long-term outcomes.