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Revista de cirugía

versión impresa ISSN 2452-4557versión On-line ISSN 2452-4549

Resumen

LOPEZ-KOSTNER, Francisco et al. Long-term results of patients with adenocarcinoma of the lower rectum treated with anterior intersphinteric ultra-low-resection. Rev. cir. [online]. 2019, vol.71, n.3, pp.238-244. ISSN 2452-4557.  http://dx.doi.org/10.4067/s2452-45492019000300238.

Introduction:

Intersphinteric resection (ISR) allows preserve sphincter function in selected patients with rectal cancer (RC). Notwithstanding, it can produce alterations in defecation.

Aim:

To analyze the oncological and functional results after an ISR.

Materials and Method:

Observational, analytical, cross-sectional study, in the period 2007-2016. Inclusion criteria: Patients submitted to ISR by RC with curative intention. All the patients had a follow-up in 2017. Analysis of functional evaluation were performed by Jorge-Wexner, LARS and Kirwan scale. Statistical analysis: Descriptive statistics and Kaplan-Meier method.

Results:

Of 21 patients; Fourteen (67%) were male, average age: 59 years. Tumor location: 4 cm (2-6 cm) from anal verge. Eighteen (85.7%) patients received neoadjuvant therapy. All distal and radial margins were negative. One patient (4.8%) had distant metastases and there was no locoregional recurrence. With a median follow-up of 76.3 (9.8-126.8) months, the 5-year global and disease-free survival was: 100% and 95% (CI: 90.1-99.9%), respectively. With a median follow-up of 90 months (21.7-124.2); Functional evaluation was performed on 15/21 patients. The Jorge-Wexner score had a median of 13 (4-17) points, the LARS scale of 34 points and in Kirwan scale, four patients (26.7%) showed good function (Kirwan I-II).

Conclusion:

The oncological results of patients undergoing ISR are satisfactory, however, functional results should be taken into account when proposing this surgical procedure.

Palabras clave : rectal cancer; intersphinteric resection; oncological results; functional results.

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