• 1. Center of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;;
  • 2. Department of Anorectal Surgical, People’s Hospital of Dianjiang County, Chongqing City, Chongqing 408300, China;
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Objective  To investigate the safety and feasibility of the total mesorectal excision (TME) and intersphincteric resection (ISR) for ultra-low rectal cancer and anal sphincter preservation surgery for anorectal cancer, and to evaluate the short term efficacy and postoperative anal function.
Methods  A retrospective analysis of clinical and follow-up data of 86 cases with TME+ISR for ultra-low rectal cancer and anorectal cancer from January 2009 to December 2010 in West China Hospital of Sichuan University were performed.
Results  Eighty-six patients were successfully performed the operation, the lower edge of tumor from the anus was 1-5 cm (average 1.63cm); tumor diameter was 2-7 cm (average 3.4cm). The tumors were high differentiation in 4 cases, moderately differentiation in 60 cases,and poorly differentiation in 22 cases. The pTNM stages were stageⅠin 12 cases, stageⅡA in 11 cases, stage ⅡB in 15 cases, stage ⅢA in 2 cases, stage ⅢB in 23 cases, stage ⅢC in 16 cases, and stage Ⅳ in 7 cases. There were postoperative anastomotic leakage in 3 cases, perianal infection in 2 cases (1 case received reoperation with permanent colostomy because of pelvic peritoneal infection caused by perianal severe infections). Anastomotic bleeding and anastomotic stenosis were of 2 cases respectively. Rectovaginal fistula, inflammatory ileus, urinary retention, and abdominal infection were of 1 case respectively. Eighty-six patients were followed-up for 12-24 months, the mean time was 18 months. Liver metastases was found in 1 case in 7 months after operation, 2 cases dead in the 7th month and 12th month after operation respectively. Local recurrence were found in 3 cases (3.5%) in 1 year after operation. The survival rate of 1-year was 97.7% (84/86). The times of defecation was 1-5 times a day. The Kirwan’s score level on function of control defecation was 1-2 grade.
Conclusions  TME+ISR for low rectal cancer and anorectal cancer is a viable, safe, and radical operation type for preservation of anus. The short term efficacy is satisfactory.

Citation: ZHENG Fang,YANG Chuanhua,WANG Xiaodong,LI Li.. Short Term Efficacy of Total Mesorectal Resection and Intersphincter Resection for Ultra-Low Rectal Cancer and Anorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(7): 753-756. doi: Copy