Intersphincteric resection with partial removal of external anal sphincter for low XXXX .

@entity1 @entity1803 @entity5 @entity189 @entity260
Abdominoperineal resection (APR) remains the standard procedure for @entity5 located within 0.5 cm from dentate line (DL). In this study, we present a new type of restorative surgery: intersphincteric resection with partial removal of external anal sphincter (EAS) and anorectal reconstruction for-ultra low @entity5 . Between March 2003 and May 2008 fifty @entity1 (28 males, aged between 39 and 71) were operated on for ultra low @entity5 uT2-3N0M0 with partial preservation of EAS and total anorectal reconstruction (smooth-muscle neosphincter and colonic pouch). A protective stoma was performed in all cases. Functional outcome and quality of life were recorded at 3, 6, 12, 18, 24 months after stoma closure using Wexner score and FIQL respectively. Anal manometry, vectrum volumetry and myography data were taken as well. Results. @entity260 developed in 2 @entity1 , but no secondary surgery was required. @entity189 were staged as pT2 (n = 14) and @entity1803 (n = 36). The distal clearance was 2.00.4 (range 1.5-2.8) cm, lateral clearance was 0.80.3 (range 0.2-1.4) cm. After a median follow-up of 24 (range 2-61) months, 2 local recurrences were occurred and salvaged by APR. Contractive activity of saved elements of EAS improved with a course of time and squeezing anal pressure increased as well. Perfect functional outcome was achieved in 25 of 34 @entity1 at 12 months after stoma closure, and all the @entity1 were satisfied with procedure. Good functional results of suggested surgery seems to be an acceptable alternative to APR with permanent stoma in selected @entity1 .
