Intersphincteric Resection: Indications and Outcome

Despite advances in the management of rectal cancer, surgery remains the mainstay of treatment with curative intent. The major advance in rectal cancer care was the standardization of surgical technique, total mesorectal excision, along with pathological reporting of the excised specimen that led to reductions in local recurrence and improved survival [1–3]. Abdominoperineal excision of the rectum (APR) was once the only option for low tumors but sphincter-preserving surgery is now commonly performed. Despite these options there exists a wide variability in the proportion of patients with rectal tumors that undergo APR (12–51%) [4–6]. The improvements in neoadjuvant therapy have led to better down staging of tumors and in some cases pathological complete response (pCR) [7]. This allows previously inoperable tumors to undergo surgical management or perform less invasive procedures such as local excision or sphincter-preserving surgery.