ArticleWorld journal of gastroenterology2025
Long-term efficacy and short-term outcomes of intersphincteric resection
Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUltra-low rectal cancer (ULRC), defined as a lesion located within 5 cm of the anal verge, poses considerable clinical challenges because the treatment decision must balance oncological eradication with preservation of anal function. Historically, abdominoperineal resection (APR) has served as a standard approach for tumor eradication in these patients, but a permanent stoma significantly reduces patients' quality of life. In contrast, intersphincteric resection (ISR) can maintain anal function, thereby improving quality of life; however, the debate surrounding short-term postoperative complications and long-term prognosis has not been fully resolved. Therefore, large-scale multicenter retrospective cohort studies are crucial to address this issue and provide more reliable data.
aimTo address a persistent debate in ULRC management, we compared ISR and APR outcomes through rigorous methodology.
methodsA retrospective analysis of patients undergoing surgery at three centers in China between 2012 and 2023 was performed with propensity score matching (PSM).
resultsA total of 803 patients (435 in the ISR group and 368 in the APR group) met the inclusion criteria, with 289 comprising each of the two groups after PSM. Over a median follow-up of 47.2 months, the absolute 5-year overall survival (OS) improved by 6.7% with ISR (80.8%
conclusionThe long-term prognosis of ULRC treated with ISR is excellent, with no increase in overall surgical complications or hospital stay duration, indicating that ISR is a feasible alternative to APR for managing ULRC.
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