Affiliation:
1. Changhai Hospital
2. University College London
3. University of Groningen
Abstract
Abstract
Purpose: Conformal sphincter preservation operation (CSPO) procedure is a sphincter preservation procedure for preserving the anal canal function for very low rectal cancers. This study investigated the functional and oncological outcome of conformal sphincter preservation operation by comparing with low anterior resection (LAR) and abdominoperineal resection (APR).
Methods: This is a retrospective comparative study. Patients who received conformal sphincter preservation operation (n=52), low anterior resection (n=54) or abdominoperineal resection (n=69) were included between 2011 and 2016 in a tertiary referral hospital. Propensity score matching was applied to adjust the baseline characteristics which may influence the choice of the surgical procedure.
Results: Twenty-one pairs of conformal sphincter preservation operation vs. low anterior resection and 29 pairs of conformal sphincter preservation operation vs. abdominoperineal resection were selected. The first group had a higher tumor location than the second group. Compared with the low anterior resection group, the conformal sphincter preservation operation group had shorter distal resection margins, however, no significant differences were identified in daily stool frequency, Wexner incontinence score, local recurrence, distant metastasis, overall survival, and disease-free survival between both groups. Compared with the abdominoperineal resection group, the conformal sphincter preservation operation group had shorter operative times and shorter postoperative hospital stay. No significant differences were identified in local recurrence, distant metastasis, overall survival, and disease-free survival.
Conclusion: Conformal sphincter preservation operation is oncologically safe compared to APR and LAR, and has similar functional findings to LAR. Studies comparing CSPO with intersphincteric resection should be performed.
Publisher
Research Square Platform LLC
Reference30 articles.
1. Sir W. Ernest Miles;Zbar AP;Tech Coloproctol,2007
2. Sphincter-saving resection for all rectal carcinomas: the end of the 2-cm distal rule;Rullier E;Ann Surg,2005
3. Resection of rectal cancer: a historical review;Inoue Y;Surg Today,2010
4. Sun G, Lou Z, Zhang H, Yu G, Zheng K, Gao X, Meng R, Gong H, Furnée E, Bai C (2020) Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer. Techniques in coloproctology
5. Nerves in the intersphincteric space of the human anal canal with special reference to their continuation to the enteric nerve plexus of the rectum;Hieda K;Clin Anat,2013