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Intersphincteric resection for low rectal tumours

R Schiessel1, J Karner-Hanusch, F Herbst

  • 1Department of Surgery, Donauspital im Sozialmedizinischen Zentrum Ost, Vienna, Austria.

The British Journal of Surgery
|September 1, 1994
PubMed
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This study details an abdominoperineal operation for low rectal tumors, achieving satisfactory continence and no mortality in 38 patients. While resting anal pressure decreased significantly, functional outcomes remained positive.

Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Low rectal tumors pose surgical challenges, often requiring abdominoperineal resection.
  • Preserving anal sphincter function is crucial for post-operative quality of life.

Purpose of the Study:

  • To describe an abdominoperineal operation technique extending rectal resection into the intersphincteric plane.
  • To evaluate the oncological and functional outcomes of this surgical approach.

Main Methods:

  • Surgical technique involves resection into the intersphincteric plane with internal sphincter removal.
  • Bowel continuity restored via coloanal anastomosis.
  • 38 patients with low rectal cancer or adenoma underwent the procedure.

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Main Results:

  • No operative mortality observed.
  • Four patients (10.5%) experienced local recurrence over a median 3-year follow-up.
  • Satisfactory fecal continence achieved in all patients.
  • Median daily bowel movements decreased from 9 to 3 within 1 year post-surgery.
  • Significant reduction in mean anal resting pressure (91.8 to 35.1 cmH2O) noted, with no recovery.

Conclusions:

  • This abdominoperineal operation is a viable option for low rectal tumors, offering good oncological control and satisfactory continence.
  • The technique results in a significant, persistent decrease in anal resting pressure but does not compromise functional outcomes.
  • Further research may explore strategies to mitigate the impact on anal resting pressure.