{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:12:45Z","timestamp":1793293965146,"version":"4.5.0"},"reference-count":34,"publisher":"Baishideng Publishing Group Inc.","issue":"29","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Gastroenterol"],"abstract":"BACKGROUND<\/jats:p>\n Ultra-low rectal cancer (ULRC), defined as a lesion located within 5 cm of the anal verge, poses considerable clinical challenges because the treatment decision must balance oncological eradication with preservation of anal function. Historically, abdominoperineal resection (APR) has served as a standard approach for tumor eradication in these patients, but a permanent stoma significantly reduces patients' quality of life. In contrast, intersphincteric resection (ISR) can maintain anal function, thereby improving quality of life; however, the debate surrounding short-term postoperative complications and long-term prognosis has not been fully resolved. Therefore, large-scale multicenter retrospective cohort studies are crucial to address this issue and provide more reliable data.<\/jats:p>\n AIM<\/jats:p>\n To address a persistent debate in ULRC management, we compared ISR and APR outcomes through rigorous methodology.<\/jats:p>\n METHODS<\/jats:p>\n A retrospective analysis of patients undergoing surgery at three centers in China between 2012 and 2023 was performed with propensity score matching (PSM).<\/jats:p>\n RESULTS<\/jats:p>\n A total of 803 patients (435 in the ISR group and 368 in the APR group) met the inclusion criteria, with 289 comprising each of the two groups after PSM. Over a median follow-up of 47.2 months, the absolute 5-year overall survival (OS) improved by 6.7% with ISR (80.8% vs 74.1%, P = 0.032). Cox regression analysis confirmed ISR (HR = 0.554, 95%CI: 0.371-0.828, P = 0.004) as an independent protective factor for OS and reduced local recurrence (9.5% vs 12.9%, P = 0.019). With respect to short-term complications, despite higher anastomotic leakage rates (11.4% vs 1.0%), ISR significantly reduced total complications (29.4% vs 42.2%, P = 0.001) and hospitalization duration (9.8 days vs 12.9 days, P < 0.001). Moreover, incision infection, urinary retention, circumferential resection margins, and hospitalization time were greater in the APR group (P < 0.05).<\/jats:p>\n CONCLUSION<\/jats:p>\n The long-term prognosis of ULRC treated with ISR is excellent, with no increase in overall surgical complications or hospital stay duration, indicating that ISR is a feasible alternative to APR for managing ULRC.<\/jats:p>","DOI":"10.3748\/wjg.v31.i29.110004","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:03:47Z","timestamp":1754352227000},"source":"Crossref","is-referenced-by-count":3,"title":["Long-term efficacy and short-term outcomes of intersphincteric resection vs<\/i> abdominoperineal resection in patients with ultra-low rectal 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