Clinical Efficacy of Intersphincteric Resection for Low Rectal Cancer Compared With Abdominoperineal Resection: A Single-Center Retrospective Study

He, Zijian; Peng, Baifu; Chen, Wenbin; Zhu, JiaDun; Chen, BaoQi; Li, Guanwei; Cao, Jie; Li, Wanglin

doi:10.1177/00031348211056271

Cited by 3 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Twenty articles 11 , 12 , 43 , 45 – 61 were included for qualitative analysis, with a total of 1217 patients in the ISR group and 1135 patients in the APR group. Among the 20 studies, eight were from Europe, 11 were from Asia, and one was from the United States.…”

Section: Resultsmentioning

confidence: 99%

“…For all available studies, five studies 46 , 48 , 50 , 53 , 61 described 5y-DFS, with a median 5y-DFS of 72% (range: 69–76.30%) after ISR and 63% (range: 42–64%) after APR, with a clear difference between the two groups. The 5y-DFS of the two groups did not differ significantly based on the pooled data from these five studies (HR: 0.84, 95% CI: 0.55–1.29; P =0.43) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Seven of the 20 studies 11 , 46 , 48 – 50 , 59 , 61 reported 5y-OS, with a median 5y-OS of 80% (range: 63–86%) after ISR and 57% (range: 46–70%) after APR, with a notable gap between the two groups. However, the pooled result showed no significant difference in 5y-OS between the two groups (HR: 0.93, 95% CI: 0.60–1.46; P =0.76).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 15 articles 11 , 12 , 45 – 47 , 49 , 51 – 54 , 56 , 57 , 59 – 61 reported postoperative LR rates, with a median LR of 7.79% (range: 0–23.33%) after ISR and 15.71% (range: 0–21.15%) after APR.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 11 studies 11 , 12 , 43 , 45 – 47 , 53 , 54 , 56 , 57 , 61 documented overall postoperative morbidity. Our review identified a median postoperative morbidity of 26.92% (range: 15.73–48.48%; 206/712) for ISR and 32.69% (range: 25.71–68.00%; 305/790) for APR.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Oncologic outcomes of intersphincteric resection versus abdominoperineal resection for lower rectal cancer: a systematic review and meta-analysis

Du¹,

Yang²,

Zhang³

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

Background: The efficacy of intersphincteric resection (ISR) surgery for patients with lower rectal cancer remains unclear compared to abdominoperineal resection (APR). The aim of this study is to compare the oncologic outcomes for lower rectal cancer patients after ISR and APR through a systematic review and meta-analysis. Materials and Methods: A systematic electronic search of the Cochrane Library, PubMed, EMBASE, and MEDLINE was performed through January 12, 2022. The primary outcomes included 5-year disease-free survival (5y-DFS) and 5-year overall survival. Secondary outcomes included circumferential resection margin involvement, local recurrence, perioperative outcomes, and other long-term outcomes. The pooled odds ratios, mean difference, or hazard ratios (HRs) of each outcome measurement and their 95% CIs were calculated. Results: A total of 20 nonrandomized controlled studies were included in the qualitative analysis, with 1217 patients who underwent ISR and 1135 patients who underwent APR. There was no significant difference in 5y-DFS (HR: 0.84, 95% CI: 0.55–1.29; P=0.43) and 5-year overall survival (HR: 0.93, 95% CI: 0.60–1.46; P=0.76) between the two groups. Using the results of five studies that reported matched T stage and tumor distance, we performed another pooled analysis. Compared to APR, the ISR group had equal 5y-DFS (HR: 0.76, 95% CI: 0.45–1.30; P=0.31) and 5y-LRFS (local recurrence-free survival) (HR: 0.72, 95% CI: 0.29–1.78; P=0.48). Meanwhile, ISR had equivalent local control as well as perioperative outcomes while significantly reducing the operative time (mean difference: −24.89, 95% CI: −45.21 to −4.57; P=0.02) compared to APR. Conclusions: Our results show that the long-term survival and safety of patients is not affected by ISR surgery, although this result needs to be carefully considered and requires further study due to the risk of bias and limited data.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Oncologic outcomes of intersphincteric resection versus abdominoperineal resection for lower rectal cancer: a systematic review and meta-analysis

Du¹,

Yang²,

Zhang³

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

show abstract

Mesorectal reconstruction with pedicled greater omental transplantation to relieve low anterior resection syndrome following total intersphincteric resection in patients with ultra-low rectal cancer

et al. 2023

View full text Add to dashboard Cite

Background Total intersphincteric resection (ISR) is the ultimate anus-preserving surgery for patients with ultra-low rectal cancer (ULRC), which can result in various degrees of anorectal dysfunction. Known as low anterior resection syndrome (LARS), it seriously affects the postoperative quality of life of patients. The aim of this study was to discuss the value of mesorectal reconstruction with pedicled greater omental transplantation (PGOT) to relieve LARS following total ISR in patients with ULRC, hoping to provide new ideas and strategies for the prevention and improvement of LARS. Methods We retrospectively analyzed hospitalization data and postoperative anorectal function of 26 ULRC patients, who were met inclusion and exclusion criteria in our center from January 2015 to February 2022. And combined with the results of anorectal manometry and rectal magnetic resonance imaging (MRI) defecography of some patients, we assessed comprehensively anorectal physiological and morphological changes of the patients after surgery, and their correlation with LARS. Results In this study, 26 patients with ULRC were enrolled and divided into observation group (n = 15) and control group (n = 11) according to whether PGOT was performed. There were no significant differences in surgical results such as operative time, intraoperative blood loss and postoperative complications between the two groups (P > 0.05). Postoperative follow-up showed that patients in both groups showed severe LARS within 3 months after surgery, but from the 3rd month after surgery, LARS in both groups gradually began to decrease, especially in the observation group, which showed faster recovery and better recovery, with statistically significant difference (P < 0.001). Through anorectal manometry, the mean rectal resting pressure in the observation group was significantly lower than that in the control group (P = 0.010). In addition, the postoperative thickness of the posterior rectal mesenterium in the observation group was significantly higher than that in the control group (P = 0.001), and also higher than the preoperative level (P = 0.018). Moreover, rectal MRI defecography showed that the neo-rectum had good compliance under the matting of greater omentum, and its intestinal peristalsis was coordinated. Conclusions ULRC patients, with the help of greater omentum, coordinated their neo-rectum peristalsis after total ISR and recovery of LARS was faster and better. PGOT is expected to be an effective strategy for LARS prevention and treatment of ULRC patients after surgery and is worthy of clinical promotion.

show abstract

Mesorectal reconstruction with pedicled greater omental transplantation to relieve low anterior resection syndrome following total intersphincteric resection in patients with ultra-low rectal cancer

Liao

Qin

Wang

et al. 2022

Preprint

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Total intersphincteric resection (ISR) is the ultimate anus-preserving surgery for patients with ultra-low rectal cancer (ULRC), which can result in various degrees of anorectal dysfunction. Known as low anterior resection syndrome (LARS), it seriously affects the postoperative quality of life of patients. The aim of this study was to discuss the value of mesorectal reconstruction with pedicled greater omental transplantation (PGOT) to relieve LARS following total ISR in patients with ULRC, hoping to provide new ideas and strategies for the prevention and improvement of LARS. METHODS We retrospectively analyzed hospitalization data and postoperative anorectal function of 26 ULRC patients, who were met inclusion and exclusion criteria in our center from January 2015 to February 2022. And combined with the results of anorectal manometry and rectal magnetic resonance imaging (MRI) defecography of some patients, we assessed comprehensively anorectal physiological and morphological changes of the patients after surgery, and their correlation with LARS. RESULTS In this study, 26 patients with ULRC were enrolled and divided into observation group (n = 15) and control group (n = 11) according to whether pedicled omental transplantation was performed. There were no significant differences in surgical results such as operative time, intraoperative blood loss and postoperative complications between the two groups (P > 0.05). Postoperative follow-up showed that patients in both groups showed severe LARS within 3 months after surgery, but from the 3rd month after surgery, LARS in both groups gradually began to decrease, especially in the observation group, which showed faster recovery and better recovery, with statistically significant differences (P < 0.001). Through anorectal manometry, the mean rectal resting pressure in the observation group was significantly lower than that in the control group (P = 0.010). In addition, the postoperative thickness of the posterior rectal mesenterium in the observation group was significantly higher than that in the control group (P = 0.001), and also higher than the preoperative level (P = 0.018). Moreover, rectal MRI defecography showed that the new rectum had good compliance under the matting of greater omentum, and its intestinal peristalsis was coordinated. CONCLUSION ULRC patients, with the help of greater omentum, coordinated their neo-rectum peristalsis after total ISR and recovery of LARS was faster and better. PGOT is expected to be an effective strategy for LARS prevention and treatment of ULRC patients after surgery and is worthy of clinical promotion.

show abstract

Clinical Efficacy of Intersphincteric Resection for Low Rectal Cancer Compared With Abdominoperineal Resection: A Single-Center Retrospective Study

Cited by 3 publications

References 30 publications

Oncologic outcomes of intersphincteric resection versus abdominoperineal resection for lower rectal cancer: a systematic review and meta-analysis

Oncologic outcomes of intersphincteric resection versus abdominoperineal resection for lower rectal cancer: a systematic review and meta-analysis

Mesorectal reconstruction with pedicled greater omental transplantation to relieve low anterior resection syndrome following total intersphincteric resection in patients with ultra-low rectal cancer

Mesorectal reconstruction with pedicled greater omental transplantation to relieve low anterior resection syndrome following total intersphincteric resection in patients with ultra-low rectal cancer

Contact Info

Product

Resources

About