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1
Ultra-low rectal cancer is defined as a tumor within 3 cm of the anal dentate line, posing challenges for surgical margin clearance and sphincter preservation.
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2
Six sphincter-preserving techniques for ultra-low rectal cancer include local excision, LAR, ISR, TaTME, and NOSES-PPS, each with distinct advantages and limitations.
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3
Postoperative anal function is a significant concern, with low anterior resection syndrome (LARS) being a common complication affecting quality of life.
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4
NOSES-PPS shows preliminary promise in preserving anal function, but current evidence is limited by small sample sizes and lack of large-scale trials.
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5
Optimal surgical outcomes depend on careful patient selection, surgical expertise, and effective perioperative management to balance oncological and functional goals.
