Intersphincteric resection for distal rectal cancer, oncological and function outcomes (short-term follow-up)

Document Type : Original Article

Authors

Surgical Oncology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446606

Abstract

Background: Intersphincteric resection (ISR) is a sphincter-sparing procedure for treating distal rectal cancer.
Aim of the work: Evaluation of oncological and functional outcomes after ISR.
Patients and methods: A prospective study comprising twenty patients with distal (low) rectal cancer discovered and treated between 2021 and 2024. All patients received neoadjuvant therapy, after which they were evaluated for eligibility for ISR. Following this, they were assessed and monitored for outcomes.
Results: The median follow-up period was 16.4 ± 2.26 months, ranging from 12 to 20 months. One patient (5%) died. Two patients (10%) experienced local recurrence (LR). Disease-free survival (DFS) was found in 17 patients (85%). Postoperative morbidity was found in the form of pelvic abscess (5%), anastomotic leak (5%), wound infection (30%), rectovaginal fistula (5%), anal stenosis (5%), and transient voiding and erectile dysfunction (15%). Functional outcomes were assessed using the Wexner score with median scores of 11, 7.5, and 5.5 at 3, 6, and 12 months, respectively, showing significant improvement over time. Good functional outcomes were noted in 14 patients (70%), while six (30%) had poor outcomes. 
Conclusion:  ISR is a viable, practical, and feasible option for LRC with satisfactory oncological and functional outcomes.

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