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Session: ePoster: Rectal Cancer 4 (Sun225)

EP535 - Short-term Outcomes Of Transanal Endoscopic Intersphincteric Resection For Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy: A Single-Center Retrospective Cohort Study

Sunday, May 11, 2025
2:57 PM – 3:02 PM PT
Location: Monitor 10, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Bo Feng (he/him/his)

    MD, PhD
    Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
    Shanghai, Shanghai, China (People's Republic)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • NA

    Naijipu Abuduaini, n/a

    MD
    Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
    shanghai, Shanghai, China (People's Republic)

    Disclosure information not submitted.

  • ZC

    Zhenghao Cai, n/a

    MD, PhD
    Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
    Shanghai, Shanghai, China (People's Republic)

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Bo Feng: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: To compare the perioperative safety and specimen characteristics after transanal endoscopic intersphincteric resection (taE-ISR) versus classical intersphincteric resection (cISR) in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT).

Methods/Interventions: Clinicopathological data of 145 patients (75 undergoing taE-ISR and 70 undergoing cISR after nCRT) were retrospectively analyzed. Baseline characteristics, perioperative details, and pathological specimen quality of the two groups were compared.

Results/Outcomes: Intraoperative blood loss was lower in the taE-ISR group compared to cISR (50.0 (40.0-100.0) ml vs. 70.0 (50.0-100.0) ml, P = 0.034). Two patients (2.6%) in the taE-ISR group and eight patients (11.4%) in the cISR group sustained adjacent organ injury (P=0.037). There was no statistically significant difference in the prevalence of postoperative complications between the two groups (17.3% vs. 30.0%, P=0.072). However, pelvic abscess (1.3% vs. 8.6%, P=0.042) and rectovaginal fistula (0.0% vs. 5.7%, P=0.036) occurred less often in taE-ISR compared to cISR. The complete resection rate was higher in taE-ISR compared to cISR (98.7% vs. 91.4%, P=0.042). No patients in taE-ISR had positive distal resection margins (DRM), while four patients in cISR had positive DRM (0.0% vs. 5.7%, P = 0.036).

Conclusion/Discussion: taE-ISR after nCRT was associated with higher-quality specimens, reduced intraoperative blood loss, and fewer perioperative complications, attesting to the feasibility and safety of taE-ISR In low-LARC patients.