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Oncologic safety and bowel function after ultralow anterior resection with or without intersphincteric resection for low lying rectal cancer: Comparative cross sectional study

Authors
 Ahmad Sakr  ;  Seung Yoon Yang  ;  Jae Hyun Kang  ;  Min Soo Cho  ;  Yoon Dae Han  ;  Byung Soh Min  ;  Waleed Thabet  ;  Hosam Ghazy Elbanna  ;  Mosaad Morshed  ;  Nam Kyu Kim 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.121(2) : 365-374, 2020-02 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2020-02
Keywords
bowel dysfunction ; low anterior resection syndrome ; rectal cancer ; sphincter-preserving surgery ; survival
Abstract
Background: Despite acceptable oncologic outcomes of sphincter preserving surgeries for low rectal cancer, bowel dysfunction occurs. This study aimed to compare the oncologic and functional bowel outcomes between ultralow anterior resection (ULAR) and intersphincteric resection (ISR) for low rectal cancer. Methods: One hundred sixty-four patients who underwent ULAR with or without ISR for low rectal cancer between December 2010 and May 2018 were included. The Wexner and Memorial Sloan Kettering Cancer Center (MSKCC) scores were used to evaluate the bowel function of patients. Overall survival (OS) and disease-free survival (DFS) were compared between patients. Results: The ISR group had higher incidence of major fecal incontinence than the ULAR group (75.9% vs 49.3%; P = .016). The median Wexner score decreased from 12 to 9 (P = .062) at 1-year follow-up. However, the frequency and urgency/soilage subscales of MSKCC score improved significantly in the ULAR group. ISR and follow-up interval less than 1-year significantly increased the major incontinence risk. The OS in the ULAR and ISR groups was 91.4% and 91.7%. Whereas the DFS in both groups was 79% and 79.2%, respectively. Conclusion: ULAR and ISR are comparable in oncologic outcomes. Severe bowel dysfunctions and major incontinence were noted in ISR group. Careful selection of patients is mandatory.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1002/jso.25791
DOI
10.1002/jso.25791
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Yang, Seung Yoon(양승윤) ORCID logo https://orcid.org/0000-0001-8129-7712
Cho, Min Soo(조민수)
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180165
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