Clinical Data Of APR And ISR Anal Preservation In Low Rectal Cancer: A Meta Analysis

Objective: Abdominoperineal resection and intersphincteric resection are two commonly used surgical procedures for low rectal cancer.By comparing the clinical data of APR and ISR,this study provided evidence based medical evidence for the selection of surgical methods for low rectal cancer.Methods databases such as Pub Med,Embase,Cochrane Library,CNKI,VIP and Wanfang were searched for "Intersphincteric Resection" and "Abdominoperineal Resection".Data were extracted and verified from the included research literatures,and the Rev Man 5.3 software was used for data processing.Results A total of 1681 cases of low rectal cancer resection were included in 12 studies,of which 975 cases were treated with ISR and706 cases were treated with APR.Compared with APR,the operative time of ISR was longer than that of APR(WMD=36.15,95%CI: 14.40-57.90,P=0.001),but the peripheral margin was negative(OR=1.87,95%CI:1.19-2.94,P=0.006),and the five-year disease-free survival rate([HR] =0.64;95% CI: 0.51 0.81;P = 0.0003)was higher than that of APR.However,there was no significant difference in intraoperative bleeding,postoperative hospital stay and postoperative complications between the two groups(all P >o.05).Conclusion For early low rectal cancer,ISR anus-preserving surgery has higher requirements on the surgeon compared with Miles surgery,but it has a good tumor outcome while preserving anus.