The paper is to discuss the advantages and technical essentials of laparoscopic inter-sphincter resection for ultra-low rectal cancer.

A total of 38 patients with ultra-low rectal cancer underwent laparoscopic inter-sphincter resection.

A total of 38 patients completed surgeries successfully, including 31 cases with partial internal sphincter resection, 6 cases with subtotal resection and 1 case with total resection. The average intraoperative bleeding amount was 168 ml (73~263 ml); the average operation time was 260 min (190~330 min); all incisal margins were negative; and the average distance from a incisal margin to tumor inferior margin was 1.56 cm (0.93~2.19 cm). There were 5 cases with postoperative anastomotic leak and 6 cases with anastomotic stenosis, and all the cases were healed with conservative treatment. No case presented pelvic or anastomotic local relapse. At 4-mo review, 1 case showed hepatic metastases and underwent hepatic metastasis resection. At 3-mo, 6-mo and 12-mo after operation, 73.3%, 83.3% and 96.7% patients obtained good functions.

With good radical therapeutic outcomes for tumor and well preserved anus function, Laparoscopic inter-sphincter resection (ISR) increase possibility of anus-preserving operation in ultra-low rectal cancer patients. Selecting proper case and standardizing operational procedures are preconditions to achieve good long-term outcomes.

Rectal neoplasms; Laparoscopes; Intersphincteric resection