Evaluation of Long-term Oncological Outcomes of Inter-Sphincter Resection Compared with Traditional Abdominoperineal Resection in Treatment of Low Rectal Cancers: A Cross Sectional Study

Objectives: abdominoperineal resection (APR), is considered the gold standard surgical treatment for low rectal cancer. Patients with low rectal tumors, tumor’s distance less than 5 cm from the anal verge, are likely to require permanent colostomy after APR. Thus, anus-preserving alternative procedures have been tested to avoid the need for permanent colostomy. the aim of the present study is to compare the functional results, and oncological outcome of traditional APR method. Methods Patients' demographic information as well as tumor characteristics were evaluated through a patient's information form. All patients were followed after the operation every three months for two years, and then every six months for at least three years. Results The study was performed on 60 patients with rectal cancer. In the group that performed APR, 9 (30%) patients developed with disease recurrence. In the ISR group, 10 (33.3%) had relapses. Based on this result, the two groups were nearly similar in the recurrence rate of disease and the difference between these two groups was not statistically significant (P value = 0.8). Conclusion In summary, the results of the present study concluded that there is no significant difference in efficacy of ISR method compared with the conventional APR in treatment of ultra-low rectal cancer. We surveyed that the ISR method is associated with beneficial long-term survival. Considering the post-operation complication associated with APR surgery including permanent colostomy, and disappointing functional outcomes, we encourage physicians to expand the use of anus-preserving procedures in treatment of low-grade distal rectal cancer.