Intersphincteric Resection for Distal Rectal Cancer Without a Defunctioning Stoma

Introduction: Between October 2010 and October 2020, were evaluated retrospectively on 192 Rectal Cancer patients underwent neoadjuvant radiotherapy, to review the surgical, oncological, and functional outcomes of an ISR without stoma. Results: 26% required partial-ISR, 48% adopted subtotal-ISR, and 26% underwent total-ISR. R0 resection was achieved in patients (96%) a colonic J pouch in 22%, a straight anastomosis in 45%, coloplasty pouch 21.9% and a side-to-end anastomosis in 15.1%. distance between the tumour and the anal verge 4 cm. Morbidity was 22% with an anastomotic Leakage average of 12%, pelvic sepsis 12%, (3.1%) developed rectovaginal fistula, anorectal anastomotic stricture 9.9%. Evaluated after 1 year, 41% reporting incontinence to gas, (38%) had nocturnal defecation. Faecal urgency was present in 26% and stools fragmentation in 46%. Discrimination between gas and stool in 71%, but 52% required anti-diarrhea medication to regulate their intestinal transit. (34%), satisfactory anal function in 65%, Distal resection margin was 2 cm (3.6%) showed positive CRM. The 5-year local recurrence (7.3%) and distant metastasis rate was 5.2%. The 5-year overall and disease-free survival rate was 71.6% and 68.3%. Conclusion: Intersphincteric resection (ISR) without protective stoma is functional and oncological safe with accepted morbidity with good quality of life.