Possibilities of minimally invasive sphincter-preserving surgery with c en-block resection of pelvic floor muscles in rectal cancer

Minimally invasive sphincter-preserving surgery for rectal cancer is a promising approach in modern oncological surgical care, helping to preserve the quality of life of patients with rectal cancer by preserving the structures of the pelvic floor and the sphincter apparatus of the rectum. One of the modern surgical techniques is the en-bloc pelvic floor muscle resection technique, which allows for the radical removal of rectal tumors with minimal damage to surrounding tissues and structures and preserves the functionality of the pelvic organs. The clinical case presented in this article illustrates the effectiveness and safety of this surgical technique, as well as the indications and contrain-dications for its use.

1. Kaprin AD, Starinsky VV. Malignant neoplasms in Russia in2018 (incidence and mortality). 2019; 250 p. (In Russ.)

2. Vorobiev GI. Colon cancer surgery. Consilium Medicum. Surgery. 2008;1:37–42. (In Russ.) https://www.elibrary.ru/rxgevd

3. Park JS, Park SY, Kim HJ, et al. Long-term oncologic outcomesafter neoadjuvant chemoradiation followed by intersphinctericresection with coloanal anastomosis for locally advanced low rectal cancer. Dis Colon Rectum. 2019;62(4):408–416.https://doi.org/10.1097/DCR.0000000000001321

4. Tulina IA, Kravchenko AYu, Tananyan AO, et al. A new look at intersphincteric resections for lower ampullary rectal cancer. Russian Medical Journal. 2014;2:22–23. (In Russ.) https://doi.org/10.17816/rmj38160

5. Kit OI, Gevorkyan YuA, Soldatkina NV, et al. Hardware interintestinal anastomosis in colorectal cancer: immediate results. Coloproctology. 2016;1(55):48–53. (In Russ.) https://doi.org/10.33878/2073-7556-2016-0-1-48-53

6. Semionkin EI, Khubezov DA, Kulikov EP, et al. Analysis of the results of anterior rectal resection. Pavlov Russian Medi-cal and Biological Bulletin. 2013;2:107–110. (In Russ.) https://doi.org/10.17816/PAVLOVJ20132107-110, https://www.elibrary.ru/rfwwkx

7. Barsukov YuA, Gordeyev SS, Tkachev SI. Possibilities of sphincter-preserving treatment of patients with locally advanced primary inoperable rectal cancer. Oncological Proctology. 2012;4:21–25. (In Russ.) https://doi.org/10.17650/2220-3478-2012-0-4-21-25

8. Fomenko OYu. Mechanisms of impairment of evacuation and retention functions in diseases of the rectum and directions of pathogenetically based diagnosis and therapy. 2017; 257 p. (In Russ.)

9. Kneist WA, Heintz A, Wolf HK, et al. Total excision of the mesorectum in cancer of the lower and middle rectum. On-cological and functional results. 2003;74(2):125–131. https://doi.org/10.1007/s00104-002-0558-6

10. Prete F, Sebastiani R, et al. Role of intersphincter resection among the surgical options for cancer of the distal rectum. Chirurgia italiana. 2001;53(6):765–772.

11. Vorobiev GI, et al. Resection of the rectum and total excision of the internal anal sphincter with smooth muscle plasty and colonic pouch for treatment of ultralow rectal carcinoma. The British journal of surgery. 2004;91(11):1506–1512. https://doi.org/10.1002/bjs.4330