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Intersphincteric Resection: Perineal or Abdominal Dissection First?

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Current Common Dilemmas in Colorectal Surgery

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Abstract

Intersphincteric resection is a surgical option in low rectal cancer. Using classification of low rectal cancer and neoadjuvant chemoradiotherapy facilitate indications. Conventionally the surgical technique is beginning by the transabdominal dissection of the mesorectum and finishes by the transanal transection of the rectum. The alternative is beginning by the transanal approach to permit a better dissection of the distal rectum. This approach can be done with conventional retractors under direct vision or with laparoscopic instruments. Some advantages of the transanal approach first are opportunities for anal sphincter sparing in difficult male obese patients, a lower conversion rate, a shorter operative time, less positive surgical margins and improved sexual function.

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Author information

Authors and Affiliations

  1. Department of Surgery, Altnagelvin Hospital, Derry, UK

    Paula Loughlin

  2. Department of Colorectal Surgery, Magellan Centre, Bordeaux University Hospital, Pessac, 33600, France

    Quentin Denost & Eric Rullier

Authors
  1. Paula Loughlin
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  2. Quentin Denost
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  3. Eric Rullier
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Correspondence to Eric Rullier .

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Editors and Affiliations

  1. London Health Sciences Centre, University Hospital, London, Ontario, Canada

    Christopher M. Schlachta

  2. Mount Sinai School of Medicine, New York, New York, USA

    Patricia Sylla

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Loughlin, P., Denost, Q., Rullier, E. (2018). Intersphincteric Resection: Perineal or Abdominal Dissection First?. In: Schlachta, C., Sylla, P. (eds) Current Common Dilemmas in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-70117-2_30

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  • DOI: https://doi.org/10.1007/978-3-319-70117-2_30

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-70117-2

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