Intersphincteric Resection and Coloanal Anastomosis

  • Min Soo Cho
  • Nam Kyu KimEmail author


Radical resection for low rectal cancer is the mainstay among the treatment modalities. Intersphincteric resection (ISR) is considered a relatively new but effective surgical treatment for low-lying rectal tumor. With the advance of treatment modality, patients who have undergone abdominoperineal resection in the past can be treated with ISR. Furthermore, preoperative chemoradiation induces tumor downstaging and facilitates anal sphincter-preserving surgery. To achieve good oncologic outcomes, appropriate patient selection based on magnetic resonance imaging (MRI) is also important because MRI provides accurate information on the extent of tumor invasion and the anal canal structures. On top of all, meticulous surgical technique based on anatomical dissection is essential. Future investigations should be directed in improving functional outcomes after ISR.


Rectal neoplasm Intersphincteric resection Coloanal anastomosis Operative technique Operative outcome 





Abdominoperineal resection


Coloanal anastomosis


Circumferential resection margin


Chemoradiation therapy


Intersphincteric resection


Magnetic resonance imaging


Total mesorectal excision


Transrectal ultrasonography


Ultralow anterior resection



The authors are deeply grateful to Dong-Su Jang, MFA, (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Korea) for his outstanding medical illustrations.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of SurgeryYonsei University College of MedicineSeoulSouth Korea

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