Table of Contents
ISRN Surgery
Volume 2012, Article ID 585484, 3 pages
Review Article

What Is the Place of Intersphincteric Resection When Operating on Low Rectal Cancer?

1Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo 135-8550, Japan
2Department of Colorectal Surgery, Concord Hospital, Sydney, NSW 2139, Australia
3Department of Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan

Received 2 May 2012; Accepted 3 July 2012

Academic Editors: E. M. Targarona, E. C. Tsimoyiannis, and J. Y. Wang

Copyright © 2012 Satoshi Nagayama et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Operating on low rectal cancer by performing an intersphincteric resection (ISR) with coloanal anastomosis has been adopted as an alternative to abdominoperineal excision (APE) following Schiessel et al. report in 1994, as it preserves the sphincter and avoids the need for a permanent stoma. We undertook a review of the recent literature specifically focusing on long-term oncologic and functional outcomes of ISR to evaluate whether this operation is a valid alternative to an APE. In conclusion, younger patients with T1 or T2 rectal cancers who require no preoperative therapy are ideal candidates for ISR, given that preoperative chemoradiotherapy may cause long-term severe anal dysfunction after ISR.