| Theme |
Current Topics Relating to the Anus |
| Title |
Intersphincteric Resection (ISR), and External Sphincteric Resection (ESR) in Patients with Extremely Low Rectal Cancer or Anal Canal Cancer |
| Author |
Tetsushi Kinugasa |
Department of Surgery, Kurume University School of Medicine |
| Author |
Yoshito Akagi |
Department of Surgery, Kurume University School of Medicine |
| Author |
Nobuya Ishibashi |
Department of Surgery, Kurume University School of Medicine |
| Author |
Kazuo Shirouzu |
Department of Surgery, Kurume University School of Medicine |
| [ Summary ] |
To avoid permanent colostomies, we performed anus preserving operations for extremely low rectal cancer or anal canal cancer. Based on our previous pathological study, two different operative methods were performed. One is intersphincteric resection (ISR), and the other is external sphincteric resection (ESR). Since 2001, these operations have been performed on patients with rectal cancer located lower than 4cm from the anal verge and with well to moderately differentiated adenocarcinoma. Five-year overall and disease-free survival rates for ISR patients were 83.8 percent and 74.8 percent, respectively. Five-year overall and disease-free survival rates for ESR patients were 100 percent and 84.4 percent, respectively. In relation to functional evaluations one year after ileostoma closure, most patients had a good levels of continence, regardless of operative methods. Both oncologic curability and functional outcomes are acceptable by employing these procedures in patients with extremely low rectal cancer or anal canal cancer. ISR and ESR are excellent procedures for the treatment of low rectal cancer and anal canal cancer extremely near the anus. |