Oncologic Outcome of Sphincter Saving Procedure vs 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: Work is to evaluate the oncologic outcome of sphincter sparing procedures compared to classic abdominoperineal resection. Patients: Group A patients (10 patients): Who meet the criteria of ISR possibility and candidates for sphincter preserving procedures Group B patients (10 patients): Who didn’t meet the criteria to do ISR, were subjected to APR. This work was conducted at Beni Suef university hospitals between January 2019 till 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: Showed that no significant difference in the rate of recurrence between the two groups. Conclusion: In low rectal cancer, sphincter saving appears to have nearly the same oncologic outcome compared to APR and in need for larger number of cases in order to support that outcome.