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J.Jpn. Surg. Soc.. 122(4): 386-391, 2021

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Department of Surgery, Kurume University School of Medicine, Kurume, Japan

Yoshito Akagi, Fumihiko Fujita, Takefumi Yoshida, Kenichi Koushi, Takafumi Ochi

A quarter of a century has passed since intersphincteric resection (ISR) was first performed as anal-conserving surgery for rectal cancer within 5 cm of the anal verge. In Japan, there were discussions concerning defecation function and curability when introducing ISR. Long-term results after ISR and defecation function results have been reported, showing that local recurrence rates are relatively low and survival rates are relatively good. However, defecation function results are not always satisfactory. We therefore reviewed the points medical facilities performing this surgical procedure had focused on. Laparoscopic surgery became popular at the same time as ISR. Laparoscopic procedures make it possible to observe the position and morphology of the sphincter and other muscles surrounding the rectum in detail. The physiological functions of the rectum and sphincter muscle are assessed in terms of the surgical procedure and postoperative complaints. ISR seems to have created greater interest in proctology in terms of the functions related to defecation and clinical anatomy.

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