Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer

Introduction: abdomino-perineal resection has been the standard treatment for rectal tumors located ≤5. cm from the anal verge. recently,intersphincteric resection became a valid option which preserves the bowel continuity with better functional outcome. aim: is to evaluate the oncological and functional outcome alongside the associated surgical morbidity in patients with t1-3 rectal cancer,who underwent intersphincteric resection (isr). patients & methods: between the years 2006 and 2011,55 patients with invasive rectal adenocarcinoma,t1-3 lesions,located 2-5. cm from the anal verge underwent isr with total mesorectal excision. when inevitable,complete. isr was performed,otherwise partial isr was done. all t3 patients underwent total meso-rectal excision (tme) while some had lateral lymph node dissection (lnd) with concomitant pelvic autonomic nerve preservation (panp). results: among the 55 patients,21 (38.1%) patients were t1-2 and 34 (61.9%) patients were t3. the tumor location range was 0-5. cm from the anal verge (median 2.3. cm). partial or complete isr was done for 35 (63.6%) and 20 (36.4%),respectively. patients were followed for a median of 1.5. years (range 1-4.6. years). the 3. year local recurrence and distant metastasis free rates were 85.2% and 85.6%,respectively. all the 3 local recurrences occurred in t3 patients group,and had positive circumferential resection margins. overall 3-year disease-free survival was 82.6%; while the overall 3-year survival was 88.7%. conclusion: intersphincteric resection with tme does not affect the local recurrence or overall survival rate in early rectal cancer t1-2 & 3,with preservation of bowel continuity and better life quality. © 2014.