{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:59:34Z","timestamp":1777456774073,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rectal cancer that grows so close to the anal canal that an adequate distal margin cannot be achieved with a double\u2010stapled anastomosis (DSA) has been managed with abdominoperineal resection. Inter\u2010sphincteric dissection and hand\u2010sewn colo\u2010anal anastomoses (HSCAA) allows anastomosis in some cases where DSA is impossible. There are concerns that HSCAA may lead to complications, local recurrence and poor continence. Our aim was to assess our experience with HSCAA in terms of recurrence, complications, continence and quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients at two metropolitan hospitals who underwent an ultra\u2010low anterior resection with hand\u2010sewn colo\u2010anal anastomoses for low rectal cancer during a 10\u2010year period were asked to complete a questionnaire which allowed continence and quality\u2010of\u2010life scores to be calculated. Recurrence and complication rates were obtained from a retrospective medical record review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 26 patients underwent HSCAA. Six patients were not sent a questionnaire (3 deaths, 1 with ileostomy, 1 with ileostomy reversal within 3\u00a0months and one who had transferred care to another hospital). Fifteen patients returned questionnaires. Local recurrence occurred in zero cases. Two developed systemic recurrence. Four patients developed anastomotic stricture and three had anastomotic leak. Median Faecal Incontinence Severity Index score was 28 and median FIQoL scores were 3.00, 2.78, 3.86 and 3.00. One patient wished that they had had a permanent stoma rather than anastomosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HSCAA delivered good local control of rectal cancer and high avoidance of permanent stoma. Faecal continence is impaired; however, the results are acceptable to the majority of patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16968","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T04:08:48Z","timestamp":1629259728000},"page":"390-396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Functional outcomes and local control are acceptable following hand\u2010sewn colo\u2010anal anastomoses for rectal cancer: Results of long\u2010term follow\u2010up"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7943-2428","authenticated-orcid":false,"given":"David","family":"Hudson","sequence":"first","affiliation":[{"name":"Department of General Surgery Sir Charles Gairdner Hospital  Perth Western Australia 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