Acquah Theophilus1,2, Zhi-Hong Chen1*, Zakari Shaibu1,2, Yu Fang1, Jun Liu1 and Muhammad Asad Iqbal1,2
1Department of Gastrointestinal Surgery, Affiliated People’s Hospital of Jiangsu University, China
2School of Medicine, Jiangsu University, China
Background: Laparoscopic transabdominal Intersphincteric Resection (ISR) is a complex and challenging operation for lower rectal cancer.
Aim: The study's objective was to evaluate and compare the postoperative outcomes between transanal intersphincteric resection and transabdominal intersphincteric resection for rectal carcinoma patients based on operative and functional outcomes.
Materials and Methods: Between January 2009 and August 2017, 53 consecutive patients with lower rectal cancer who underwent laparoscopic curative ISR treatment were evaluated from the Department of Gastrointestinal Surgery, Affiliated People’s Hospital of Jiangsu University. Patient groups were classified into as TA-ISR (n=31) and LT-ISR (n=22) groups.
Results: In total, 53 patients were analyzed. The studies investigated postoperative outcomes such as operative results, morbidity, mortality, and postoperative follow-up results. The operation's mean duration was 212 (69.9) in the transanal ISR and 180.1 (36.7) in the laparoscopic transabdominal ISR. The blood loss in the two groups was 68.7 (32.4) and 78.4 (37.9), respectively. Nevertheless, there was no perioperative mortality, complications occurred in 7 patients, and the morbidity rate was 16.1% (5/31) in the transanal ISR, including one anastomotic leakage, one anastomotic stricture, one urinary retention, 1 intra-abdominal abscess, and one subclinical dehiscence and 9.1% (2/22) in the laparoscopic transabdominal ISR consisting of 1 anastomotic stricture and 1 urinary retention and all patients with complications were managed through conservative treatments.
The postoperative local recurrence was 12.9% in the transanal ISR and 4.5% with the laparoscopic transabdominal ISR.
Conclusion: Transanal and laparoscopic transabdominal ISR yielded similar operative and functional outcomes in patients with lower rectal cancer, despite the difference in follow-up time.
Internal sphincter resection; Laparoscopic surgery; Intersphinteric resection; Rectal cancer
Theophilus A, Chen Z-H, Shaibu Z, Fang Y, Liu J, Iqbal MA. Transanal vs. Laparoscopic Transabdominal Intersphincteric Resection for Lower Rectal Cancer: Comparison of the Operative and Functional Outcomes. Clin Oncol. 2021;6:1792..