Evidence Review
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 107525
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.107525
Sphincter-preserving surgical techniques in low rectal cancer management: A systematic review of contemporary evidence
Song Wang, A-Jian Li, Hui-Hong Jiang, Yin Lin, Hai-Bo Ding
Song Wang, A-Jian Li, Hui-Hong Jiang, Yin Lin, Hai-Bo Ding, Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China
Author contributions: Wang S drafted the manuscript; Li AJ, Jiang HH, and Lin Y revised the manuscript; Wang S and Ding HB jointly reviewed and edited the manuscript. All authors have read and approved the final version to be published.
Conflict-of-interest statement: All the authors declare that they have no relevant conflicts of interest regarding this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Bo Ding, PhD, Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, No. 450 Tengyue Road, Shanghai 200090, China. 2812097576@qq.com
Received: March 30, 2025
Revised: April 17, 2025
Accepted: May 28, 2025
Published online: July 27, 2025
Processing time: 115 Days and 20.2 Hours
Core Tip

Core Tip: The adoption of total mesorectal excision (TME) principle and better understanding of circumferential resection margin have led to the development of various sphincter-preserving surgeries, such as local excision, Dixon surgery, intersphincteric resection, etc. Minimally invasive methods such as laparoscopic, robotic and natural orifice transluminal endoscopic surgery improve operational precision and postoperative recovery. New perineal reconstruction techniques also benefit some patients. However, the high incidence of low anterior resection syndrome (LARS) and its sequelae are notable. Long-course neoadjuvant radiotherapy and TME are key risk factors for LARS.