摘要
AIM： To analyze oncological outcome of intersphincteric resection （ISR） in ultra-low rectal cancer with intent to spare colostoma. METHODS： From 1995 to 1998, patients with a nonfixed rectal adenocarcinoma （tumor stage T2） preserving the lower margin at 1-3 cm above the dentate line without distant metastasis was enrolled （period I）. ISR was practiced in eight patients, and their postoperative followup was at least 5 years. In addition, from 1999 to 2003, another 10 patients having the same tumor location as period Ⅰ underwent ISR （period Ⅱ）. Among those, 6 patients with T3-4-staged tumor received preoperative chemoradiotherapy. RESULTS： All patients received ISR with curative intention and no postoperative mortality. In these case series at period Ⅰ, local recurrence rate was 12.5% and metastasis rate 25.0%; the S-year survival rate was 87.5% and disease-free survival rate 75.0%. There was no local recurrence or distant metastases in 10 patients with a median follow-up of 30 （range, 18-47） mo at period Ⅱ. CONCLUSION： As to ultra-low rectal cancer, intersphincteric resection could provide acceptable local control and cancerrelated survival with no permanent stoma in early-staged tumor （tumor stage T2）; more- over, preoperative concurrent chemoradiotheraw would make ISR feasible with surgical curative intent in more advanced tumors （tumor stages T3-4）.
瞄准：与节省 colostoma 的目的在极端低的直肠的癌症分析 intersphincteric 切除术(ISR ) 的 oncological 结果。方法：从 1995 ～ 1998，有没有远转移，在齿状线上面在 1-3 厘米保存更低的边缘的非修理的直肠的腺癌(肿瘤阶段 T2 ) 的病人被注册(时期我) 。ISR 在八个病人被练习，并且他们的手术后的后续是至少 5 年。另外从 1999 ～ 2003，另一作为时期有一样的肿瘤地点的 10 个病人我经历了 ISR (时期 II ) 。在那些之中，有 T3-4-staged 肿瘤的 6 个病人收到了外科手术前的 chemoradiotherapy。结果：所有病人与药品意愿和没有手术后的死亡收到了 ISR。在在时期的这些情况系列我，本地再发率是 12.5% 和转移率 25.0% ；5 年的幸存率是 87.5% 和没有疾病的幸存率 75.0% 。在有 30 的中部的后续的 10 个病人没有本地复发或远转移(范围， 18-47 ) 在时期 II 的瞬间。结论：至于极端低的直肠的癌症， intersphincteric 切除术能在早阶段的肿瘤(肿瘤阶段 T2 ) 没有永久气孔提供可接受的本地控制和癌症相关的幸存；而且，外科手术前的并发的 chemoradiotherapy 将在更先进的肿瘤(肿瘤阶段 T3-4 ) 与外科的药品目的使 ISR 可行。
