Review of Intersphincteric Resections for Rectal Cancer Treatment

Colorectal cancer is the third most common cancer, second in women, and fourth leading cause of death world. Radical surgical treatment with Total Mesorectal Excision (TME) considered best for found lower rectum has benefits complete tumor removal to reduce risk recurrence improve survival. Advances preoperative chemoradiation therapy have increased chances achieving a 1 cm distal margin allowed successful sphincter-preserving surgery by intersphincteric resection (ISR) Coloanal Anastomosis (CAA) that allows normal defecation. MRI particularly useful evaluating localization tumor, involvement anal sphincter (internal external sphincters), levator ani muscles, adjacent structures anus, an accuracy 85%, sensitivity 87%, specificity 75%. Performing ISR TME oncologic principles achieves similar results Low Anterior Resection (LAR), but depends on presence sufficient Distal Rectal Margin (DRM); if DRM cannot be achieved, then patients are offered Abdominoperineal (APR) permanent colostomy poor quality-of-life results.