Pull-through and conformal resection for very low rectal cancer: a more satisfactory technique for anal function after sphincter preserving operation

© Annals of Laparoscopic and Endoscopic Surgery. All rights reserved. Ann Laparosc Endosc Surg 2016;1:24 ales.amegroups.com When a rectal cancer is located at less than 5 cm from the anal verge (very low rectal cancer), abdominoperineal resection (APR) was generally performed (1). However, the patient’s quality of life can be compromised by the social and psychological limitations of a permanent stoma (2). Recently, intersphincteric resection (ISR) with coloanal anastomosis (CAA) and were proposed as alternative procedures to avoid APR (3-5). However, patients undergoing ISR generally have direct impairment of anal sphincter function because the anal internal sphincter, as a part of the anal sphincter complex, is removed. Moreover, dentate line is also removed resulting in an impairment of sensibility and hence also to more incontinence. Therefore, the functional outcomes of ISR or PISR remain an important issue because of sphincter damage and sensory loss (6-9). An ideal procedure for very low rectal cancer should combine a satisfied preservation of sphincter function with oncological safety. Based on the previous study, we proposed a pull-through and conformal resection technique (PTCR) Review Article