Laparoscopic intersphincteric resection of rectal cancer with posterior vaginal wall excision without hysterectomy

Excerpt

Abdominoperineal resection (APR) had been routinely performed for low rectal cancer regardless of its depth of invasion until Schiessel et al. reported intersphincteric resection in 1994 [1]. From around 2000 onward, as preoperative chemoradiotherapy became the standard treatment of advanced low rectal cancer for local control and tumor shrinkage, sphincter preservation techniques came to be widely used. Laparoscopic surgery for rectal cancer is now performed worldwide, but the benefit of laparoscopic surgery for rectal cancer compared to open surgery is still controversial [2, 3]. One of the reasons might be the difficulty in achieving negative circumferential resection margins (CRM) [4]. A clear margin can be more easily obtained in female patients compared to male patients because of the existence of the vagina (Fig. 1). We performed laparoscopic intersphincteric resection with posterior vaginal wall excision for women with advanced anterior wall low rectal cancer to prevent positive CRM. To the best of our knowledge, this procedure has not been described in the literature. The aim of our study was to assess the outcomes of this novel procedure. …