Intersphincteric resection (ISR) is a surgical approach that allows resection of low lying rectal cancers that abut or invade the sphincter complex while avoiding the creation of a permanent stoma. While removing a portion of or the entire internal anal sphincter, the goal of therapy is complete extirpation of the cancer while preserving the external sphincter for anastomosis and preservation of continence through the anal canal. The critical considerations revolve around cancer outcomes (local and distant recurrence rates), as well as bowel function/continence. These issues, as well as the technical steps, will be reviewed in this presentation.
Upon completion of this module, participants should be able to:
- Explain the indications and contraindications for intersphincteric resection in the setting of low lying rectal cancer.
- Explain the step of ISR procedure.
- Explain the published data related to cancer outcomes and functional outcomes.
As a Weekly Curriculum module, it is eligible for 1 AMA PRA Category 1 Credit™.
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