Surgical Endoscopy

, Volume 31, Issue 11, pp 4466–4471 | Cite as

Anorectal complications after robotic intersphincteric resection for low rectal cancer

  • Li-Jen KuoEmail author
  • 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



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.


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.


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).


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.


Anal stenosis Intersphincteric resection Mucosal prolapse Rectal cancer Robotic surgery 


Compliance with ethical standards


Dr. Li-Jen Kuo, Dr. James Chi-Yong Ngu, Dr. Yan-Jiun Huang, Mr. Yen-Kuang Lin, Dr. Chia-Che Chen, Dr. Yiu-Shun Tong, Ms. Szu-Chia Huang, Ms. Chia-Chen Hu and Ms. Shu-Hwa Tan have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Li-Jen Kuo
    • 1
    • 2
    Email author
  • James Chi-Yong Ngu
    • 3
  • Yan-Jiun Huang
    • 1
    • 4
  • Yen-Kuang Lin
    • 5
  • Chia-Che Chen
    • 6
  • Yiu-Shun Tong
    • 6
  • Szu-Chia Huang
    • 7
  • Chia-Chen Hu
    • 1
  • Shu-Hwa Tan
    • 8
  1. 1.Division of Colorectal Surgery, Department of SurgeryTaipei Medical University HospitalTaipeiTaiwan
  2. 2.Department of Surgery, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  3. 3.Department of SurgeryChangi General HospitalSingaporeSingapore
  4. 4.The Ph.D. Program for Translational Medicine, College of Medical Science and TechnologyTaipei Medical University and Academia SinicaTaipeiTaiwan
  5. 5.Biostatistics and Research Consultation CenterTaipei Medical UniversityTaipeiTaiwan
  6. 6.Division of Acute Care Surgery and Traumatology, Department of SurgeryTaipei Medical University HospitalTaipeiTaiwan
  7. 7.Department of Physical Medicine and RehabilitationTaipei Medical University HospitalTaipeiTaiwan
  8. 8.Department of NursingTaipei Medical University HospitalTaipeiTaiwan

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