Feasibility of Sphincter Saving in Comparison to Abdominoperineal Resection

Abstract

Introduction: 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: Is to assess the feasibility of sphincter sparing procedure compared to classic abdominoperineal resection. Patient: Group A patients (10 patients): who meet the criteria of intersphincteric resection (ISR) possibility and candidates for sphincter saving procedures Group B patients (10 patients): who didn’t meet the criteria to do ISR, were subjected to abdominoperineal resection (APR). This work was conducted at Beni Suef university hospital between January 2019 and March 2020. Methods: A. 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: The incidence of complications were higher without significance in sphincter saving group of patients (wound infection- burst abdomen-paralytic ileus-skin maceration). Conclusion: In low rectal cancer, the sphincter saving appears to be feasible with little complications that worth the avoidance of APR permanent dysfunctions