low rectal cancer | Acta Medica Marisiensis

Intersphincteric Resection for Low Rectal Cancer – Case Report

Russu Cristian¹, Molnar Călin^1*, Copotoiu Sanda Maria², Sărăcuț Claudiu¹, Gherghinescu Mircea¹, Molnar Varlam Claudiu³, Copotoiu Constantin¹

1 Surgical Clinic 1 of the Emergency County Hospital and the University of Medicine and Pharmacy of Tîrgu Mureș, Romania
2 Anesthesia and Intensive Care Clinic 1 of the Emergency County Hospital and the University of Medicine and Pharmacy of Tîrgu Mureș, Romania
3 Obstetric-Gynecology Clinic, Clinical Emergency County Hospital Tirgu Mures, University of Medicine and Pharmacy Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0118

Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter’s function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome.
Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions) followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up.
Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.

Sphincter Saving Techniques in Low Rectal Cancer Surgical Treatment: Results, Perspectives

Russu C¹, Copotoiu C¹, Bud V², Saracut C², Gherghinescu M¹, Molnar Varlam C³, Molnar C¹

¹ University of Medicine and Pharmacy of Tirgu Mures, Surgical Clinic no. 1, County Clinical Emergency Hospital Targu Mures, Romania
² County Clinical Emergency Hospital Targu Mures, Romania
³ University of Medicine and Pharmacy of Tirgu Mures, Obstetrics and Gynecology Clinic no. 1, County Clinical Emergency Hospital Targu Mures, Romania

DOI: 10.1515/amma-2015-0013

Objective: Sphincter saving techniques in low rectal cancer represents a challenge for the surgeons in their attempt to preserve the sphincter function and also to respect the principles of oncological surgery, in order to improve the quality of the patient’s life. The paper’s aim is to compare different sphincter saving techniques in regards to the early postoperative results.
Methods: An observational, retrospective study was performed on 76 patients (N = 76) operated for low rectal cancer in the Surgical Clinic no.1 of the Targu Mures Emergency Clinical County Hospital, between January 2010 and October 2014, to whom the rectal resection was followed by a primary restorative technique for preservation of the sphincter function. The immediate postoperative results after different types of sphincter saving procedures were analyzed and compared.
Results: From the studied patients, in 41 cases (53.94%) an anterior rectal resection with low colorectal anastomosis was done („very low” Dixon procedure), for 29 patients (38.15%) a sphincter saving technique with a peranal anastomosis was performed and in 6 cases (7.89%) an intersphinteric rectal resection with coloanal anastomosis was made.
Conclusions: Sphincter saving techniques, if oncological principles are respected, represents a viable option in the treatment of low rectal cancer and brings hope for improving the quality of the patients’ life.