Sphincter-Sparing Surgery in Patients with Low-Lying Rectal Cancer: Techniques, Oncologic Outcomes, and Functional Results

Liliana Bordeianou, Lillias H Maguire, Karim Alavi, Ranjan Sudan, Paul E. Wise, Andreas M. Kaiser

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Background: Rectal cancer management has evolved into a complex multimodality approach with survival, local recurrence, and quality of life parameters being the relevant endpoints. Surgical treatment for low rectal cancer has changed dramatically over the past 100 years. Discussion: Abdominoperineal resection, once the standard of care for all rectal cancers, has become much less frequently utilized as surgeons devise and test new techniques for preserving the sphincters, maintaining continuity, and performing oncologically sound ultra-low anterior or local resections. Progress in rectal cancer surgery has been driven by improved understanding of the anatomy and pathophysiology of the disease, innovative surgical technique, improved technology, multimodality approaches, and increased appreciation of the patient's quality of life. The patient with a low rectal cancer, once almost universally destined for impotence and a colostomy, now has the real potential for improved survival, avoidance of a permanent stoma, and preservation of the normal route of defecation.

Original languageEnglish (US)
Pages (from-to)1358-1372
Number of pages15
JournalJournal of Gastrointestinal Surgery
Volume18
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • Anterior resection
  • Intersphincteric resection
  • Local excision rectal cancer
  • Rectal cancer
  • Sphincter preservation
  • Total mesorectal excision

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