{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:21:51Z","timestamp":1740126111986,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,1,21]],"date-time":"2015-01-21T00:00:00Z","timestamp":1421798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Grants-in-Aid for Scientific Research"},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The indications for intersphincteric (<jats:styled-content style=\"fixed-case\">ISR<\/jats:styled-content>) anterior resection are not clearly defined. The aim of this study was to evaluate vertical extension of T2 or T3 low rectal cancer treated by rectal amputation to optimize patient selection for <jats:styled-content style=\"fixed-case\">ISR<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The abdominoperineal excision specimens of T2 or T3 low rectal cancer from 53 patients treated between 1992 and 2004 were retrospectively reviewed. Vertical invasion was quantified by measuring the shortest distance between the tumour and the striated muscle (T\u2010<jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content>), assuming that this represented the surgical margin that would have be achieved had an <jats:styled-content style=\"fixed-case\">ISR<\/jats:styled-content> been performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Involvement of the dentate line (<jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>) and intramural distal spread were independent risk factors for T\u2010<jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content> \u2264\u00a02\u00a0mm. The T\u2010<jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content> was less when the inferior border of the tumour was on the distal side of the <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content> (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.572, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The probability of involvement of the <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>, intramural distal spread or either one of these being associated with T\u2010<jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content>\u00a0\u2264\u00a02\u00a0mm was 43, 46 and 43%, respectively. All patients without both intramural distal spread and involvement of the <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content> had T\u2010<jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content>\u00a0&gt;\u00a02.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We recommend that <jats:styled-content style=\"fixed-case\">ISR<\/jats:styled-content> should only be performed for patients with T2 or T3 low rectal cancer in whom the lowest edge of the tumour is above the <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content> and there is no intramural distal spread. Such patients are relatively unlikely to have a T\u2010<jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content> \u2264\u00a02\u00a0mm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12769","type":"journal-article","created":{"date-parts":[[2014,9,10]],"date-time":"2014-09-10T10:21:07Z","timestamp":1410344467000},"page":"133-140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing the selection of patients with low rectal cancer for intersphincteric resection by evaluating vertical invasion to the levator and external sphincter"],"prefix":"10.1111","volume":"17","author":[{"given":"K.","family":"Narui","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Yokohama City University Graduate School of Medicine Yokohama Japan"},{"name":"Gastroenterological Center Yokohama City University Medical Center Yokohama 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