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A Porcine Model of Laparoscopic Intersphincteric Resection for Ultra-Low Rectal Cancer.

Min-Wei Zhou1, Ji-Xin Ma1, Zheng-Qing Yan1

  • 1Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China.

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
|May 7, 2025
PubMed
Summary

A new porcine model for laparoscopic intersphincteric resection (ISR) was developed for ultra-low rectal cancer. The model showed promising results with no major complications and preserved anal function post-surgery.

Keywords:
intersphincteric resectionmodelingporcineultra-low rectal cancer

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Area of Science:

  • Surgical innovation
  • Animal models
  • Gastrointestinal surgery

Background:

  • Ultra-low rectal cancer requires specialized surgical techniques like intersphincteric resection (ISR).
  • Developing reliable animal models is crucial for advancing surgical procedures and understanding treatment outcomes.
  • Laparoscopic approaches offer potential benefits in minimally invasive surgery for rectal cancer.

Purpose of the Study:

  • To establish a reproducible porcine model for performing laparoscopic intersphincteric resection (ISR).
  • To evaluate the feasibility and safety of the laparoscopic ISR procedure in a porcine model.
  • To assess the functional outcomes, specifically anal function, following laparoscopic ISR in pigs.

Main Methods:

  • Six Bama mini-pigs underwent a standardized laparoscopic ISR procedure, including vessel ligation, autonomic nerve sparing, rectal dissection, and transanal dissection.
  • The procedure involved dissection of the intersphincteric space (ISS) and completion with an end-to-end handsewn coloanal anastomosis (CAA).
  • Postoperative pathological evaluations and weekly fecal incontinence assessments over 12 weeks were conducted.

Main Results:

  • All pigs survived the laparoscopic ISR without conversion to open surgery or major complications like anastomotic leakage.
  • Minor postoperative issues such as constipation and anal redness resolved within a week.
  • Postoperative fecal incontinence scores at three months showed no significant abnormalities compared to preoperative assessments, indicating preserved anal function.

Conclusions:

  • A replicable porcine model for laparoscopic ISR has been successfully established.
  • This model demonstrates the potential for use in preclinical research for ultra-low rectal cancer treatment.
  • The study highlights the feasibility of laparoscopic ISR with preserved anal function in this animal model.