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Tulina I.A.

Otdelenie koloproktologii s khirurgieĭ tazovogo dna

Bredikhin M.I.

State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Department of colorectal and endoscopic surgery

Gerasimov A.N.

Sechenov First Moscow State Medical University, Moscow, Russia

Krylov N.N.

Klinika fakul'tetskoĭ khirurgii #1 lechebnogo fakul'teta Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova

Reshetov I.V.

Scientific and Clinical and Educational center for Plastic Surgery of University’s Clinical Hospital №1 of I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Tsar'kov P.V.

Chair of Cardiovascular Surgery and Interventional Cardiology, I.M. Sechenov First Moscow State Medical University (head — MD R.N. Komarov), acad. B.V. Petrovsky Russian Research Center for Surgery (director — acad. of RAS Yu.V. Belov), Moscow, Russia

Intersphincteric resection for stage I-III low rectal cancer is an oncologically safe alternative to extralevator abdomino-perineal rectal resection

Authors:

Tulina I.A., Bredikhin M.I., Gerasimov A.N., Krylov N.N., Reshetov I.V., Tsar'kov P.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2017;(4): 61‑68

DOI: 10.17116/hirurgia2017461-68

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To cite this article:

Tulina IA, Bredikhin MI, Gerasimov AN, Krylov NN, Reshetov IV, Tsar'kov PV. Intersphincteric resection for stage I-III low rectal cancer is an oncologically safe alternative to extralevator abdomino-perineal rectal resection. Pirogov Russian Journal of Surgery. 2017;(4):61‑68. (In Russ.)
https://doi.org/10.17116/hirurgia2017461-68

Подписка 2025 (Pirogov Russian Journal of Surgery)
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Aim. To compare oncologic efficiency of intersphincteric resections and extralevator abdominoperineal excisions in surgical treatment of low rectal cancer. Methods. Between 2006 and 2015 in Department of colorectal and pelvic floor surgery (Russian scientific center of surgery n.a. acad. B.V. Petrovsky) and in Clinic of Colorectal and Minimally invasive surgery (Sechenov First Moscow State Medical University) 40 consecutive patients underwent intersphincteric resection (ISR) and 31 underwent extralevator abdominoperineal excision (EAPE). All patients had low rectal cancer staged I-III within 5 cm from the anal verge. Results. Circular resection margin >1 mm was achieved in 95% and 84% of patients after ISR and EAPR correspondingly (p=0.002), negative distal resection margin was achieved in 95% of ISR patients. In ISR group mean distance from the lower tumor edge to the distal resection margin was 1,17±0,78 cm. Colo-anal anastomosis leak rate was 17%. The 3-year disease-free survival in ISR group was 97%, 5-year disease-free survival was 93%. The 5-year disease-free survival in stage III for ISR group was 71,4%. In 98% of ISR patients complete restoration of bowel continuity was performed.

Keywords:

rectal cancer
intersphincteric resection (ISR)
abdominoperineal Resection (APR)
extralevator abdominoperineal excision (ELAPE)
surgical resection margin
circular resection margin (CRM)
distal resection margin (DRM)
survival

Authors:

Tulina I.A.

Otdelenie koloproktologii s khirurgieĭ tazovogo dna

Bredikhin M.I.

State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Department of colorectal and endoscopic surgery

Gerasimov A.N.

Sechenov First Moscow State Medical University, Moscow, Russia

Krylov N.N.

Klinika fakul'tetskoĭ khirurgii #1 lechebnogo fakul'teta Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova

Reshetov I.V.

Scientific and Clinical and Educational center for Plastic Surgery of University’s Clinical Hospital №1 of I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Tsar'kov P.V.

Chair of Cardiovascular Surgery and Interventional Cardiology, I.M. Sechenov First Moscow State Medical University (head — MD R.N. Komarov), acad. B.V. Petrovsky Russian Research Center for Surgery (director — acad. of RAS Yu.V. Belov), Moscow, Russia

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