Comparison of Complications and Outcomes of Very Low Anterior Resection (VLAR) Versus Intersphentric Resection (ISR) In Patients with Rectal Cancer.

Background: Colorectal cancer is a cancer that starts in the colon or rectum, which are part of the digestive system. Intersphincteric resection (ISR) and very low anterior resection (VLAR) are surgical procedures used in rectal malignancy. We aimed to compare postoperative complications and recurrence after VLAR and ISR techniques in patients with rectal cancer.

Methods: In this retrospective study, 80 rectal cancer patients who underwent VLRA and ISR in Shahid Faghihi, and Abu-Ali Sina Charity Hospitals, Shiraz, Iran from 2019 to 2023 were enrolled. Eligible patients were divided into two groups based on the type of operation. One group underwent VLAR (n=40) and the second group of patients underwent ISR(n=40). Postoperative complications and outcomes were compared between the two groups.

Results: The mean age in VLAR and ISR groups was 52.8±14.3 and 54.3±11.6 years, respectively. Low anterior resection syndrome was not significantly different between the two groups (P=0.39). Postoperative fecal incontinence was observed in 27.5% and 22.5% of VLAR and ISR groups, respectively. This difference was not statistically significant (P=0.91). Rectovaginal fistula was reported in 2.5% of patients in both groups (P=0.61).

Conclusion: There was no difference in postoperative complications in VLAR and ISR techniques. Considering the lack of significant difference in the complications of the two surgical groups, it is suggested to choose the surgical method based on the location of the tumor.