Status and prospect of anus-preserving operation for low rectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHOU Tong ^1,2,3 , LI Lifa ^1,3

1. Department of General Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
2. Department of Surgery, The Second Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
3. Institute of Hepatobiliary, Pancreatic and Intestinal Disease, North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding?author：

ZHOU Tong, Email: zhoutong0088@163.com

Keywords：

low rectal cancer; anus-preserving; intersphincteric resection; transanal total mesorectal excision

DOI：

10.7507/1007-9424.201807054

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate current status of anal sphincter preservation in low rectal cancer.Method The recent literatures on the progress of anal sphincter preservation in the low rectal cancer were reviewed.Results In the past, the surgical treatment of the low rectal cancer was mainly based on the Miles. With the deepening of the anatomical understanding, the improvement of surgical concepts, and the development of minimally invasive techniques, the treatment concept of the low rectal cancer had gradually entered the era of retaining anal and anal function. At present, many surgical methods including the transanal local excision, intersphincteric resection, transanal total mesorectal excision, etc. could be applied to the anal sphincter preservation of the lower rectal cancer, but the advantages and disadvantages of each surgical procedure and the scope of application were slightly different.Conclusions Although there are many surgical procedures that can be applied to patients with low rectal cancer, none of them can achieve perfection in terms of retaining anal and anal function, reducing complications and recurrence rates, and improving survival. It is believed that with continuous understanding of rectal anatomy by surgeons, emergence of various neoadjuvant chemoradiation and new devices, and more anal sphincter preservation procedures and even artificial anal surgery, treatment of low rectal cancer will also be more good care for anal and maintenance function, so that patients can obtain a higher quality and a long-term survival opportunity.

Citation： ZHOU Tong, LI Lifa. Status and prospect of anus-preserving operation for low rectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(2): 236-240. doi: 10.7507/1007-9424.201807054 Copy

1.	Miles WE. A method of performing abdomino-perineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon (1908). CA Cancer J Clin, 1971, 21(6): 361-364.
2.	Dixon CF. Anterior resection for malignant lesions of the upper part of the rectum and lower part of the sigmoid. Trans Meet Am Surg Assoc Am Surg Assoc, 1948, 66(Trans. 68. meeting): 175-192.
3.	Schiessel R, Karner-Hanusch J, Herbst F, et al. Intersphincteric resection for low rectal tumours. Br J Surg, 1994, 81(9): 1376-1378.
4.	Bregendahl S, Emmertsen KJ, Lous J, et al. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis, 2013, 15(9): 1130-1139.
5.	Williams NS, Dixon MF, Johnston D. Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: a study of distal intramural spread and of patients’ survival. Br J Surg, 1983, 70(3): 150-154.
6.	Emile SH, de Lacy FB, Keller DS, et al. Evolution of transanal total mesorectal excision for rectal cancer: From top to bottom. World J Gastrointest Surg, 2018, 10(3): 28-39.
7.	Cheregi CD, Simon I, Fabian O, et al. Mechanical suture in rectal cancer. Clujul Med, 2017, 90(3): 305-312.
8.	Moore HG, Riedel E, Minsky BD, et al. Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy. Ann Surg Oncol, 2003, 10(1): 80-85.
9.	Martella A, Willett C, Palta M, et al. The selective use of radiation therapy in rectal cancer patients. Curr Oncol Rep, 2018, 20(6): 43.
10.	Escal L, Nougaret S, Guiu B, et al. MRI-based score to predict surgical difficulty in patients with rectal cancer. Br J Surg, 2018, 105(1): 140-146.
11.	Okafor PN, Swanson K, Shah N, et al. Endoscopic ultrasound for rectal cancer staging: A population-based study of utilization, impact on treatment patterns, and survival. J Gastroenterol Hepatol, 2018, 33(8): 1469-1476.
12.	Liu Y, Lu XM, Tao KX, et al. Anatomical basis and clinical research of pelvic autonomic nerve preservation with laparoscopic radical resection for rectal cancer. J Huazhong Univ Sci Technolog Med Sci, 2016, 36(2): 211-214.
13.	Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc, 1991, 1(3): 144-150.
14.	Nonaka T, Fukuda A, Maekawa K, et al. The feasibility and efficacy of laparoscopic extended total mesorectal excision for locally advanced lower rectal cancer. In Vivo, 2018, 32(3): 643-648.
15.	Chen H, Ma B, Gao P, et al. Laparoscopic intersphincteric resection versus an open approach for low rectal cancer: a meta-analysis. World J Surg Oncol, 2017, 15(1): 229.
16.	Williams NS, Murphy J, Knowles CH. Anterior perineal plane for ultra-low anterior resection of the rectum (the APPEAR technique): a prospective clinical trial of a new procedure. Ann Surg, 2008, 247(5): 750-758.
17.	劉寶華. 直腸癌局部切除術的國內外進展. 中國普外基礎與臨床雜志, 2011, 18(11): 1132-1134.
18.	Skibber JM. Local excision for rectal cancer. J Natl Compr Canc Netw, 2005, 3(4): 531-539.
19.	夏立建. 直腸腫瘤局部切除技術的現狀. 中華腫瘤防治雜志, 2008, 15(13): 961-964.
20.	邱輝忠, 林國樂, 吳斌, 等. Parks手術在低位直腸癌術中的保肛作用. 癌癥進展, 2004, 2(6): 420-422.
21.	賈學軍, 趙曉偉. 改良式Bacon術作為低位直腸癌器械吻合失敗后補救手術的臨床應用. 中國腫瘤臨床, 2008, 35(4): 227-228.
22.	汪建平. 低位直腸癌術式選擇及評價. 中國實用外科雜志, 2017, 37(6): 593-595.
23.	周宗進, 吳安定, 金朝霞, 等. 腹腔鏡下低位直腸癌改良Bacon術臨床應用分析. 臨床外科雜志, 2017, 25(1): 67-69.
24.	Kuo LJ, Hung CS, Wu CH, et al. Oncological and functional outcomes of intersphincteric resection for low rectal cancer. J Surg Res, 2011, 170(1): e93-e98.
25.	Koyama M, Murata A, Sakamoto Y, et al. Long-term clinical and functional results of intersphincteric resection for lower rectal cancer. Ann Surg Oncol, 2014, 21 Suppl 3: S422-S428.
26.	Dumont F, Ayadi M, Goéré D, et al. Comparison of fecal continence and quality of life between intersphincteric resection and abdominoperineal resection plus perineal colostomy for ultra-low rectal cancer. J Surg Oncol, 2013, 108(4): 225-229.
27.	Park JS, Choi GS, Jun SH, et al. Laparoscopic versus open intersphincteric resection and coloanal anastomosis for low rectal cancer: intermediate-term oncologic outcomes. Ann Surg, 2011, 254(6): 941-946.
28.	Kim CH, Lee SY, Kim HR, et al. Factors associated with oncologic outcomes following abdominoperineal or intersphincteric resection in patients treated with preoperative chemoradiotherapy: a propensity score analysis. Medicine (Baltimore), 2015, 94(45): e2060.
29.	Kim HS, Ko S, Oh NG. Long-term results of extended intersphincteric resection for very low rectal cancer: a retrospective study. BMC Surg, 2016, 16: 21.
30.	Atallah S, Albert M, Monson JR. Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Tech Coloproctol, 2016, 20(7): 483-494.
31.	楊選華, 田云鴻, 黃斌, 等. 經肛門全直腸系膜切除術的研究進展. 中國普外基礎與臨床雜志, 2017, 24(11): 1408-1413.
32.	Chouillard E, Regnier A, Vitte RL, et al. Transanal NOTES total mesorectal excision (TME) in patients with rectal cancer: Is anatomy better preserved? Tech Coloproctol, 2016, 20(8): 537-544.
33.	Xu W, Xu Z, Cheng H, et al. Comparison of short-term clinical outcomes between transanal and laparoscopic total mesorectal excision for the treatment of mid and low rectal cancer: A meta-analysis. Eur J Surg Oncol, 2016, 42(12): 1841-1850.
34.	Penna M, Hompes R, Arnold S, et al. Transanal total mesorectal excision: international registry results of the first 720 cases. Ann Surg, 2017, 266(1): 111-117.
35.	Tuech JJ, Karoui M, Lelong B, et al. A step toward NOTES total mesorectal excision for rectal cancer: endoscopic transanal proctectomy. Ann Surg, 2015, 261(2): 228-233.
36.	Meillat H, de Chaisemartin C, Poizat F, et al. Combined NOTES total mesorectal excision and single-incision laparoscopy principles for conservative proctectomy: a single-centre study. Tech Coloproctol, 2017, 21(1): 43-51.
37.	Al Furajii H, Kennedy N, Cahill RA. Abdomino-endoscopic perineal excision of the rectum for benign and malignant pathology: Technique considerations for true transperineal verus transanal total mesorectal excision endoscopic proctectomy. J Minim Access Surg, 2017, 13(1): 7-12.

1. Miles WE. A method of performing abdomino-perineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon (1908). CA Cancer J Clin, 1971, 21(6): 361-364.
2. Dixon CF. Anterior resection for malignant lesions of the upper part of the rectum and lower part of the sigmoid. Trans Meet Am Surg Assoc Am Surg Assoc, 1948, 66(Trans. 68. meeting): 175-192.
3. Schiessel R, Karner-Hanusch J, Herbst F, et al. Intersphincteric resection for low rectal tumours. Br J Surg, 1994, 81(9): 1376-1378.
4. Bregendahl S, Emmertsen KJ, Lous J, et al. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis, 2013, 15(9): 1130-1139.
5. Williams NS, Dixon MF, Johnston D. Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: a study of distal intramural spread and of patients’ survival. Br J Surg, 1983, 70(3): 150-154.
6. Emile SH, de Lacy FB, Keller DS, et al. Evolution of transanal total mesorectal excision for rectal cancer: From top to bottom. World J Gastrointest Surg, 2018, 10(3): 28-39.
7. Cheregi CD, Simon I, Fabian O, et al. Mechanical suture in rectal cancer. Clujul Med, 2017, 90(3): 305-312.
8. Moore HG, Riedel E, Minsky BD, et al. Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy. Ann Surg Oncol, 2003, 10(1): 80-85.
9. Martella A, Willett C, Palta M, et al. The selective use of radiation therapy in rectal cancer patients. Curr Oncol Rep, 2018, 20(6): 43.
10. Escal L, Nougaret S, Guiu B, et al. MRI-based score to predict surgical difficulty in patients with rectal cancer. Br J Surg, 2018, 105(1): 140-146.
11. Okafor PN, Swanson K, Shah N, et al. Endoscopic ultrasound for rectal cancer staging: A population-based study of utilization, impact on treatment patterns, and survival. J Gastroenterol Hepatol, 2018, 33(8): 1469-1476.
12. Liu Y, Lu XM, Tao KX, et al. Anatomical basis and clinical research of pelvic autonomic nerve preservation with laparoscopic radical resection for rectal cancer. J Huazhong Univ Sci Technolog Med Sci, 2016, 36(2): 211-214.
13. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc, 1991, 1(3): 144-150.
14. Nonaka T, Fukuda A, Maekawa K, et al. The feasibility and efficacy of laparoscopic extended total mesorectal excision for locally advanced lower rectal cancer. In Vivo, 2018, 32(3): 643-648.
15. Chen H, Ma B, Gao P, et al. Laparoscopic intersphincteric resection versus an open approach for low rectal cancer: a meta-analysis. World J Surg Oncol, 2017, 15(1): 229.
16. Williams NS, Murphy J, Knowles CH. Anterior perineal plane for ultra-low anterior resection of the rectum (the APPEAR technique): a prospective clinical trial of a new procedure. Ann Surg, 2008, 247(5): 750-758.
17. 劉寶華. 直腸癌局部切除術的國內外進展. 中國普外基礎與臨床雜志, 2011, 18(11): 1132-1134.
18. Skibber JM. Local excision for rectal cancer. J Natl Compr Canc Netw, 2005, 3(4): 531-539.
19. 夏立建. 直腸腫瘤局部切除技術的現狀. 中華腫瘤防治雜志, 2008, 15(13): 961-964.
20. 邱輝忠, 林國樂, 吳斌, 等. Parks手術在低位直腸癌術中的保肛作用. 癌癥進展, 2004, 2(6): 420-422.
21. 賈學軍, 趙曉偉. 改良式Bacon術作為低位直腸癌器械吻合失敗后補救手術的臨床應用. 中國腫瘤臨床, 2008, 35(4): 227-228.
22. 汪建平. 低位直腸癌術式選擇及評價. 中國實用外科雜志, 2017, 37(6): 593-595.
23. 周宗進, 吳安定, 金朝霞, 等. 腹腔鏡下低位直腸癌改良Bacon術臨床應用分析. 臨床外科雜志, 2017, 25(1): 67-69.
24. Kuo LJ, Hung CS, Wu CH, et al. Oncological and functional outcomes of intersphincteric resection for low rectal cancer. J Surg Res, 2011, 170(1): e93-e98.
25. Koyama M, Murata A, Sakamoto Y, et al. Long-term clinical and functional results of intersphincteric resection for lower rectal cancer. Ann Surg Oncol, 2014, 21 Suppl 3: S422-S428.
26. Dumont F, Ayadi M, Goéré D, et al. Comparison of fecal continence and quality of life between intersphincteric resection and abdominoperineal resection plus perineal colostomy for ultra-low rectal cancer. J Surg Oncol, 2013, 108(4): 225-229.
27. Park JS, Choi GS, Jun SH, et al. Laparoscopic versus open intersphincteric resection and coloanal anastomosis for low rectal cancer: intermediate-term oncologic outcomes. Ann Surg, 2011, 254(6): 941-946.
28. Kim CH, Lee SY, Kim HR, et al. Factors associated with oncologic outcomes following abdominoperineal or intersphincteric resection in patients treated with preoperative chemoradiotherapy: a propensity score analysis. Medicine (Baltimore), 2015, 94(45): e2060.
29. Kim HS, Ko S, Oh NG. Long-term results of extended intersphincteric resection for very low rectal cancer: a retrospective study. BMC Surg, 2016, 16: 21.
30. Atallah S, Albert M, Monson JR. Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Tech Coloproctol, 2016, 20(7): 483-494.
31. 楊選華, 田云鴻, 黃斌, 等. 經肛門全直腸系膜切除術的研究進展. 中國普外基礎與臨床雜志, 2017, 24(11): 1408-1413.
32. Chouillard E, Regnier A, Vitte RL, et al. Transanal NOTES total mesorectal excision (TME) in patients with rectal cancer: Is anatomy better preserved? Tech Coloproctol, 2016, 20(8): 537-544.
33. Xu W, Xu Z, Cheng H, et al. Comparison of short-term clinical outcomes between transanal and laparoscopic total mesorectal excision for the treatment of mid and low rectal cancer: A meta-analysis. Eur J Surg Oncol, 2016, 42(12): 1841-1850.
34. Penna M, Hompes R, Arnold S, et al. Transanal total mesorectal excision: international registry results of the first 720 cases. Ann Surg, 2017, 266(1): 111-117.
35. Tuech JJ, Karoui M, Lelong B, et al. A step toward NOTES total mesorectal excision for rectal cancer: endoscopic transanal proctectomy. Ann Surg, 2015, 261(2): 228-233.
36. Meillat H, de Chaisemartin C, Poizat F, et al. Combined NOTES total mesorectal excision and single-incision laparoscopy principles for conservative proctectomy: a single-centre study. Tech Coloproctol, 2017, 21(1): 43-51.
37. Al Furajii H, Kennedy N, Cahill RA. Abdomino-endoscopic perineal excision of the rectum for benign and malignant pathology: Technique considerations for true transperineal verus transanal total mesorectal excision endoscopic proctectomy. J Minim Access Surg, 2017, 13(1): 7-12.

Previous Article
Advances in research on role of methylation and its mechanism in liver fibrosis
Next Article
Advances in surgical treatment of colorectal cancer based on mesenteric anatomy

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Status and prospect of anus-preserving operation for low rectal cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content