Costanzo A, Rampulla V and Petrelli F
The intersphinteric technique was initially described by Schiessel et al. in 1994. It has gradually spread to Europe and Asia: it has progressively established itself also through laparoscopy and robotics. The largest published series are Asian, and the last review is by Japanese author Kazuo Shirouzu et al. Indications: adenocarcinoma of the low rectum “c” or ycT1-T3N0/+, within 1 cm of the anorectal ring, without involvement of the intersphincter plane. Contraindications: G3-G4 tumours, cT4 (external sphincter invasion, puborectalis muscle, prostate, vagina), distant metastases, tumour fixity to rectal exploration, sphincteric hypotonia, psychiatric comorbidity, moderate-severe cardio-respiratory, renal or hepatic comorbidity.
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