Ali Naki Yücesoy

Clinic of General Surgery, Private Batı Bahat Hospital, İstanbul, Turkey

Abstract

Objective: To define the techniques used in lower rectal cancer surgery, by transvaginal and transperineal approach; extrasphincteric dissection, proximal segmental sphincteric excision and transsphincteric rectal resection.
Material and Methods: Between 2007 and 2013, 7 patients (4 female, 3 male with lower rectal cancer were operated by sphincter-saving extrasphincteric disection and proksimal sphincteric excision techniques. After completion of the rectosigmoid dissection and total mesorectal excision up to the puborectal muscle level; extrasphincteric rectal dissection, transsphincteric rectal resection and ultra-low coloanal anastomosis were performed by using the transvaginal and transperineal approach in the sublevator phase of the operation.
Results: Seven patients were operated with sublevator access for lower rectal cancer. Bowel contiunity has been provided in all patients. One patient died due to surgical complications in the early postoperative period. One patient deceveloped anastomotic leakage and there were two patients with anastomotic stricture. Circumferential resection margin and tumoral perforation were found negative in all of the patients. Tumoral deposits at the distal resection line was observed in one patient.
Conclusion: The techniques of sublevator rectal resection may be considered as an alternative sphincter-saving surgical method, especially in lower rectal cancer surgery.

Keywords: Lower rectal cancer, sphincter-saving extrasphincteric dissection, proximal segmental sphincteric excision, transsphincteric rectal resection


 

Ethics Committee Approval

Our Institutional Review Board application was not accepted because of the hospital I work is not a research and education hospital.

Peer Review

Externally peer-reviewed.

Conflict of Interest

No conflict of interest was declared by the author.

Financial Disclosure

The authors declared that this study has received no financial support.