Anorectal function after partial intersphincteric resection in ultra-low rectal cancer.

AIM: To investigate the feasibility and efficacy of intersphincteric resection (ISR), in terms of postoperative anorectal function, for ultra-low rectal cancer in mainland China.

METHOD: A total of 43 patients who consecutively underwent curative partial ISR for ultra-low rectal cancer between 2006 and 2009 were enrolled in the study. Defaecatory function was assessed, using detailed questionnaires, 3, 6 and 12 months after surgery. The Wexner score was used to assess faecal continence, and anal manometry studies were performed to analyse anal sphincter function.

RESULTS

Overall defaecatory function was assessed as being satisfactory in 41 of 43 patients. Twelve months after surgery, the mean Wexner score was 4.0 ± 3.6. Anal manometry studies showed a significant change at 3 months and further, gradual, improvement over the following year. During the postoperative period, maximum squeeze pressure reached a normal value of 174.1 ± 19.5 mmHg (P = 0.041) by 6 months and resting pressure was 42.4 ± 5.6 mmHg by 12 months, which was close to the preoperative level (P = 0.038).

CONCLUSION

Because of the satisfactory recovery of defaecatory function and good oncological results, partial ISR may be recommended as an effective sphincter-preserving operation for patients with ultra-low rectal cancer.