{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:15:55Z","timestamp":1790345755645,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,5]],"date-time":"2020-09-05T00:00:00Z","timestamp":1599264000000},"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":["Colorectal Disease"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>There are few data evaluating the long\u2010term outcomes of intersphincteric resection (ISR), especially the impact of inclusion of more juxtapositioned and intra\u2010anal tumours on oncological and functional outcomes. We compared the oncological and functional results of patients treated by total mesorectal excision and ISR for low rectal cancer over a 25\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This is a retrospective study from a single institution evaluating results of ISR over three periods: 1990\u20131998, 1999\u20132006 and 2007\u20132014. Patients treated by partial or total ISR, with or without neoadjuvant chemoradiotherapy, for low rectal cancer (\u2264\u00a06\u00a0cm from the anal verge) were included. We compared postoperative morbidity, quality of surgery and oncological and functional outcomes in the time periods studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 813 patients operated on for low rectal cancer, 303 had ISR. Tumour stage did not differ; however, the distance of the tumour from the anorectal junction decreased from 1 to 0\u00a0cm (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and the distal resection margin shortened from 25 to 10\u00a0mm (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) from 1990 to 2014. The postoperative morbidity and quality of surgery did not change significantly over time. The 5\u2010year local recurrence (4.3% <jats:italic>vs<\/jats:italic> 5.9%\u00a0<jats:italic>vs<\/jats:italic> 3.5%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.741) and disease\u2010free survival (72%\u00a0<jats:italic>vs<\/jats:italic> 71%\u00a0<jats:italic>vs<\/jats:italic> 75%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.918) did not differ between the three time periods. Functional results improved during the last period; however, overall 42% of patients experienced major bowel dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pushing the envelope of sphincter\u2010saving resection in ultra\u2010low rectal cancer reaching or invading the anal sphincter did not compromise oncological and functional outcomes. The main limitation of the ISR procedure appears to be functional rather than oncological, suggesting that bowel rehabilitation programmes should be developed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15258","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T13:24:51Z","timestamp":1594387491000},"page":"1603-1613","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Intersphincteric resection for low rectal cancer: the risk is functional rather than oncological. A 25\u2010year experience from Bordeaux"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3088-5244","authenticated-orcid":false,"given":"Q.","family":"Denost","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery CHU Bordeaux Haut\u2010Leveque Hospital University of Bordeaux Pessac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u2010B.","family":"Moreau","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery CHU Bordeaux Haut\u2010Leveque Hospital University of Bordeaux Pessac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Vendrely","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy CHU Bordeaux Haut\u2010Leveque Hospital University of Bordeaux Pessac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Celerier","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery CHU Bordeaux Haut\u2010Leveque Hospital University of Bordeaux Pessac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rullier","sequence":"additional","affiliation":[{"name":"Department of Pathology CHU Bordeaux Pellegrin Hospital University of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Assenat","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery CHU Bordeaux Haut\u2010Leveque Hospital University of Bordeaux Pessac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Rullier","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery CHU Bordeaux Haut\u2010Leveque Hospital University of Bordeaux Pessac France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.133.8.894"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i7.855"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800700305"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000103070.13030.eb"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810944"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02238569"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000154551.06768.e1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000766"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001991"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.5858\/133.10.1539"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.07.010"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824f1c21"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050307"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31821d3677"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-003-0088-4"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463-1318.2003.00508.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4330"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200204000-00001"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02238025"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.05.036"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1991.01410360108018"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(98)00180-1"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(99)00099-1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200111000-00008"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6172-6"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.08.170"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318195e17c"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31827c4a8c"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12003"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00004-2"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001078"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2000.103487"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2003.11.011"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31815c29ff"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200102000-00001"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13124"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001089"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.15258","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15258","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.15258","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T19:17:00Z","timestamp":1692991020000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.15258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,5]]},"references-count":38,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/codi.15258"],"URL":"https:\/\/doi.org\/10.1111\/codi.15258","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,5]]},"assertion":[{"value":"2019-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}