Short Term Outcome of Sphincter Saving Procedure in Low Rectal Cancer

Intersphincteric resection of low rectal tumors is a surgical technique extending rectal resection into the intersphincteric space. This procedure is performed by a synchronous abdominoperineal approach with mesorectal excision and excision of the entire or part of the internal sphincter.

Aim of the Work: Aim of the work is to evaluate the oncological and functional outcome of sphincter saving procedures.

Patients: 10 patients who meet the criteria of ISR possibility and candidates for sphincter saving procedures this study was conducted al Beni Suef University hospital between January 2019 and March 2020.

Methods: Total ISR involves complete excision of the internal sphincter. The cut line is at the intersphincteric groove. B. Subtotal ISR involves partial excision of the internal sphincter. The cut line is between the dentate line and the intersphincteric groove. C. Modified partial ISR the cut line is below the dentate line on one side of the tumor. On the opposite side of the tumor, the cut line is above the dentate line. D. Partial ISR the cut line is at or above the level of the dentate line.

Results: Results showed that out of 10 patients underwent ISR, 6 patients were highly satisfied with Grade I continence according to Kirwan’s grade. While 4 patients were Grade II, i.e.: Incontinent to flatus. 30% rate of recurrence.

Conclusion: In low rectal cancer, the sphincter saving appears to have acceptable oncologic outcome. However, patients with sphincter saving have certainly demonstrated an indisputable faire functional outcome, in terms of stoma avoidance and adequate continence.