Preservation and Restoration of Sphincter Function in Patients with Rectal Cancer

Radical resection of rectal cancer is the standard treatment for curing this disease. Half of these tumours are located in the rectosigmoid region or the upper third of the rectum and are, therefore, easily resectable with preservation of the sphincter muscles, thus guaranteeing acceptable continenc...

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Main Authors: Rudolf Schiessel, Harald R Rosen
Format: Article
Language:English
Published: Wiley 2000-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2000/215353
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author Rudolf Schiessel
Harald R Rosen
author_facet Rudolf Schiessel
Harald R Rosen
author_sort Rudolf Schiessel
collection DOAJ
description Radical resection of rectal cancer is the standard treatment for curing this disease. Half of these tumours are located in the rectosigmoid region or the upper third of the rectum and are, therefore, easily resectable with preservation of the sphincter muscles, thus guaranteeing acceptable continence in most patients. However, tumours that originate in the lower parts of the rectum have been accompanied with the need for an abdominoperineal resection and the threat of a permanent colostomy. In the past 20 years, sphincter-saving surgery has become increasingly common in the treatment of tumours of the middle and low rectum due to the knowledge of tumour growth, the use of stapling devices, and the knowledge of the physiology of the pelvic floor and the sphincter muscles, respectively. Recent surgical techniques of resection of the ’ultralow’ rectum (intersphincteric resection) and the reconstruction by coloanal anastomosis are reviewed. Functional problems following ultralow resections are emphasized, as well as the possibility of sphincter restoration after abdominoperineal resection by use of dynamic graciloplasty. Taking all surgical options into account, a permanent colostomy for rectal cancer can be avoided in most curatively and electively operated patients.
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spelling doaj-art-c44e549a426147ceab4daede18b21fa12025-02-03T01:09:34ZengWileyCanadian Journal of Gastroenterology0835-79002000-01-0114542342610.1155/2000/215353Preservation and Restoration of Sphincter Function in Patients with Rectal CancerRudolf Schiessel0Harald R Rosen1Ludwig Boltzmann Research Institute for Surgical Oncology, Danube Hospital, Vienna, AustriaLudwig Boltzmann Research Institute for Surgical Oncology, Danube Hospital, Vienna, AustriaRadical resection of rectal cancer is the standard treatment for curing this disease. Half of these tumours are located in the rectosigmoid region or the upper third of the rectum and are, therefore, easily resectable with preservation of the sphincter muscles, thus guaranteeing acceptable continence in most patients. However, tumours that originate in the lower parts of the rectum have been accompanied with the need for an abdominoperineal resection and the threat of a permanent colostomy. In the past 20 years, sphincter-saving surgery has become increasingly common in the treatment of tumours of the middle and low rectum due to the knowledge of tumour growth, the use of stapling devices, and the knowledge of the physiology of the pelvic floor and the sphincter muscles, respectively. Recent surgical techniques of resection of the ’ultralow’ rectum (intersphincteric resection) and the reconstruction by coloanal anastomosis are reviewed. Functional problems following ultralow resections are emphasized, as well as the possibility of sphincter restoration after abdominoperineal resection by use of dynamic graciloplasty. Taking all surgical options into account, a permanent colostomy for rectal cancer can be avoided in most curatively and electively operated patients.http://dx.doi.org/10.1155/2000/215353
spellingShingle Rudolf Schiessel
Harald R Rosen
Preservation and Restoration of Sphincter Function in Patients with Rectal Cancer
Canadian Journal of Gastroenterology
title Preservation and Restoration of Sphincter Function in Patients with Rectal Cancer
title_full Preservation and Restoration of Sphincter Function in Patients with Rectal Cancer
title_fullStr Preservation and Restoration of Sphincter Function in Patients with Rectal Cancer
title_full_unstemmed Preservation and Restoration of Sphincter Function in Patients with Rectal Cancer
title_short Preservation and Restoration of Sphincter Function in Patients with Rectal Cancer
title_sort preservation and restoration of sphincter function in patients with rectal cancer
url http://dx.doi.org/10.1155/2000/215353
work_keys_str_mv AT rudolfschiessel preservationandrestorationofsphincterfunctioninpatientswithrectalcancer
AT haraldrrosen preservationandrestorationofsphincterfunctioninpatientswithrectalcancer