Suboptimal Uptake of Sphincter Saving Resection for Low Carcinoma Rectum: Applied Anatomy of the Sphincter Shows the Way Forward

Abdominoperineal resection (APR) has been conventionally performed for low and ultra-low rectal carcinoma; but now the oncological long-term successful outcome of sphincter-saving resection (SSR) in these cases have been demonstrated. Despite the possibility of a significantly better quality of life and equivalent, if not better oncological outcome, APRs continue to be performed at a varied rate instead of SSR. Limited understanding of sphincter anatomy and the fear of incontinence among the surgeons are the main reasons for suboptimal uptake of SSR. Knowledge of sphincter preservation during surgery for anorectal malformation in children provides understanding of applied anatomy and can be used for SSR, being presented as point of view.