Excision of the levator muscles with external sphincter preservation in the treatment of selected low T4 rectal cancers.

摘要: PURPOSE: The existence of an anatomic and functional separation between the puborectalis muscle external anal sphincter permits performance abdominoendoanal excision, instead abdominoperineal rectum levator muscles, with preservation a functioning sphincter, in selected patients very low rectal cancer limited infiltration muscles. METHODS: Seven (4 females; age, 48–69; mean, 60.7 ± 7.8 years) posterior or posterolateral localized cancers (T4) were submitted to preoperative chemoradiation excision while its innervation preserved. A coloanal anastomosis was performed at dentate line. RESULTS: At median follow-up 58 (range, 42–102) months, 6 (86 percent) alive disease free. No local recurrence observed. Anorectal function, three years from surgery no worse than that six same age gender who had undergone more conventional anastomoses CONCLUSION: Selected infiltrating muscles responding therapy can still be treated advanced sphinctersparing procedure, excision. Oncologic results seem satisfactory.