Intersphincteric resection for low rectal tumors

The technical development of rectal surgery, together with chemo- and radiotherapy, improved the effi ciency of surgical intervention as well as the patients‘ survival and quality of life. The treatment of ultra deep malignancies – 2-3 cm from linea dentata – is a real challenge for rectal surgery. Before the introduction of laparoscopy the removal of the deep tumors with conventional surgical techniques was impossible to save the tumorous rectum. The new techniques made possible the ultra deep resection, i.e. the removal even those tumors which progressed until the linea dentata. The explosive use of laparoscopy and the new waves of chemo- and radiotherapy resulted signifi cance advance contributed to an interdisciplinary therapeutic approach, which is a well adapted method in deep rectal surgery. In case of ultra deep localization of tumors – 0.5–1.0 cm to linea dentata – the neoadjuvant therapy supported the saving the anal sphicter. This new techniques contributed to the preservation of feces continentia of the patient.