Intersphincteric resection and coloanal anastomosis in the treatment of distal rectal cancers  

作　　者：Shailesh P.Puntambekar Nikesh M.Gandhi Mohammed Azharuddin AAttar Suyog Bharambe Ravindra Sathe Mangesh Panse Mihir Chitale Kshitij Manerikar Sravya Inampudi Aishwarya Puntambekar 

机构地区：[1]Department of Minimal Access Surgery,Galaxy Care Laparoscopic Institute,Pune,Maharashtra 411004,India

出　　处：《Laparoscopic, Endoscopic and Robotic Surgery》2023年第2期57-62,共6页腔镜、内镜与机器人外科（英文）

摘　　要：Objective:In the evolving era of minimal access surgery,low rectal cancers still pose a challenge to laparoscopic or robotic surgeons.Hence,at our institute we intended to demonstrate the oncological efficacy of intersphincteric resection and coloanal anastomosis in the treatment of distal rectal cancers,performing the abdominal part of the procedure which includes rectal mobilization,laparoscopically.Methods:From February 2017 to March 2021,125 patients who had undergone intersphincteric resection and coloanal anastomosis via the perineal approach at Galaxy Care Laparoscopic Institute,Pune,were included in this study.Transabdominal mobilization of the rectum was performed laparoscopically.All patients had a diversion ileostomy and a pelvic drain.Patients were followed-up for a period of 18 months post-surgery.Data on clinical and oncological outcomes were collected and analysed.The pre-operative and post-operative Wexner incontinence scores were compared.Results:The mean time taken for surgery was 181.57±30.00 min.The mean blood loss was 119.76±42.53 mL.Most patients(103,82.4%)had their tumour at a distance of 1e2 cm from the anal verge.A loco-regional recurrence rate of 12.8%(16/125)was noted in our study.For the post-surgery Wexner score,74.4% of patients(93/125)had a score of 5 or less,depicting that three-quarters of the study population had satisfactory continence.Overall,81.6%of patients were satisfied with the functional results of surgery.Conclusion:Intersphincteric resection and coloanal anastomosis,with a 12.8%recurrence rate,can now be considered an oncological and technically feasible procedure with sphincter salvage and good continence.

关 键 词：Intersphincteric resection Coloanal anastomosis LAPAROSCOPY CONTINENCE 

分 类 号：R735.37[医药卫生—肿瘤]