Intersphincteric Resection for Low Rectal Cancer – Case Report

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Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter’s function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome. Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions) followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up. Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.

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  • 1. Bisceglia G Mastrodonato N Tardio B et al. Intermediate neoadjuvant adiotherapy for T3 low/middle rectal cancer: Postoperative outcomes of a non-controlled clinical trial. 4294367 Oncotarget. 2014;5(22):11143-11153.PMCID:4294367

  • 2. Mulsow J Winter DC. Sphincter preservation for distal rectal cancer - a goal worth achieving at all costs? World J Gastroenterol 2011;17(7):855-861.doi:10.3748/wjg.v17.i7.855

  • 3. Spanos C P. Intersphincteric resection for low rectal cancer: An overview. Int J Surg Oncol. 2012;2012:241512.doi:10.1155/2012/241512

  • 4. Musio D De Felice F Bulzonetti N et al. Neoadjuvant-intensified treatment for rectal cancer: Time to change? World J Gastroenterol. 2013;19(20):3052-3061.doi:10.3748/wjg.v19.i20.3052

  • 5. Schiessel R Novi G Holzer B et al. Technique and long-term results of intersphincteric resection for low rectal cancer. Dis Colon Rectum 2005;48:1858-1867.doi:10.1007/s10350-005-0134-5

  • 6. Heald R J. The ’holy plane’ of rectal surgery. J R Soc Med 1988;81(9):503-508.doi:10.1177/014107688808100904

  • 7. Cipe G Muslumanoglu M Yardimci E Memmi N Aysan E. Intersphincteric resection and coloanal anastomosis in treatment of distal rectal cancer. Int J Surg Oncol. 2012;2012:581258.doi:10.1155/2012/581258

  • 8. Jorge JM Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36(1):77-97

  • 9. Deo S V S Kapali A S Gupta M Shukla N K. A review of controversies in the management of colorectal cancers. Indian J Surg. 2012;74(3):221-227.doi:10.1007/s12262-012-0586-5

  • 10. Rullier E Goffre B Bonnel C Zerbib F Caudry M Saric J. Preoperative radiochemotherapy and sphincter-saving resection for T3 carcinomas of the lower third of the rectum. Ann Surg. 2001;234(5):633-640. PMCID:1422087

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