Anorectal complications after robotic intersphincteric resection for low rectal cancer

Li Jen Kuo, James Chi Yong Ngu, Yan Jiun Huang, Yen Kuang Lin, Chia Che Chen, Yiu Shun Tong, Szu Chia Huang, Chia Chen Hu, Shu Hwa Tan

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Background: Robotic intersphincteric resection (ISR) has been introduced for sphincter-preservation in the treatment of low rectal cancer. However, many patients experience anorectal symptoms and defecatory dysfunction after ISR. This study aims to evaluate the anorectal complications that develop after ISR. Methods: The medical records of 108 patients who underwent robotic ISR at Taipei Medical University Hospital, Taipei, Taiwan between December 2011 and June 2016 were retrospectively reviewed. Photographic records of perineal conditions were documented at the following time intervals after surgery: 1 day, 2 weeks, 1, 2, 3 and 6 months. Clinical outcomes and treatment results were analysed. Results: Eighty-five patients (78.7%) developed edematous hemorrhoids after surgery. These subsided at a median of 56 days after operation (range 23–89 days). Forty-six patients (42.6%) were found to have anal stenosis requiring anal dilatation. Sixteen patients (14.8%) had neorectal mucosal prolapse, which was noted to occur at an average of 98 days after surgery (range 41–162 days). Multivariate analysis showed that the occurrence of edematous hemorrhoids was associated with operating time (P = 0.043), and male gender was a significant risk factor for anal stenosis (P = 0.007). Conclusions: This is the first study reporting on the clinical outcomes of anorectal status after robotic ISR. Further studies are needed to assess the long-term effects of these anorectal complications.

Original languageEnglish
Pages (from-to)4466-4471
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Issue number11
Publication statusPublished - Nov 1 2017


  • Anal stenosis
  • Intersphincteric resection
  • Mucosal prolapse
  • Rectal cancer
  • Robotic surgery

ASJC Scopus subject areas

  • Surgery


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