Push-back technique facilitates ultra-low anterior resection without nerve injury in total mesorectal excision for rectal cancer

Yasuhiro Inoue, Junichiro Hiro, Yuji Toiyama, Koji Tanaka, Keiichi Uchida, Chikao Miki, Masato Kusunoki

研究成果: Article査読

3 被引用数 (Scopus)

抄録

Aims: To describe our push-back approach to ultra-low anterior resection using the concept of the mucosal stump. Methods: We mobilize the rectum using an abdominal approach, and perform mucosal cutting circumferentially at the dentate line. The mucosal stump is closed, and the internal sphincteric muscle resected partially or totally according to tumor location. Perianal dissection is performed along the medial plane of the external sphincteric muscles, and the hiatal ligament is dissected posteriorly. To resect the entire rectum, the closed rectal stump is pushed back to the abdominal cavity using composed gauze. This prevents injury to the autonomic nerve. Results: We performed colonic J-pouch anal anastomosis using our mucosal stump approach in 58 patients with rectal cancer located <4 cm from the anal verge. According to the Wexner score, 7% of patients were fully continent, 71% had acceptable function with minor continence problems, and 22% were incontinent. No patients required intermittent self-catheterization during follow-up. After a median follow-up of 49 months, there was only 1 case of local recurrence after surgery. Conclusion: Our push-back approach for internal sphincter resection produces satisfactory functional and oncological results in ultra-low anterior rectal cancer.

本文言語English
ページ(範囲)239-244
ページ数6
ジャーナルDigestive Surgery
28
4
DOI
出版ステータスPublished - 10-2011
外部発表はい

All Science Journal Classification (ASJC) codes

  • 外科
  • 消化器病学

フィンガープリント

「Push-back technique facilitates ultra-low anterior resection without nerve injury in total mesorectal excision for rectal cancer」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル