Antegrade Enema After Excision For Rectal Cancer To Cure Anterior Resection Syndrome

BackgroundAt present,the treatment of middle and low rectal cancer mainly follows the principle of TME,which is a comprehensive therapy based on surgery,supplemented by radiotherapy and chemotherapy,and has achieved good results in tumor curative effect.However,more and more patients suffered from low anterior resection syndrome(LARS).The combination of increased stool frequency,urgency,clustering,and fecal incontinence after anterior resection with anastomosis is often referred to as LARS.The clinical treatments effect for LARS are still unsatisfactory.ObjectiveWe assessed the functional results of patients treated by antegrade enema for middle and low rectal cancer after sphincter-preserving surgery,so as to provide an effective therapy measure for the recovery of anorectal function.MethodsThis is a single-centered prospective study.60 patients with low rectal cancer who underwent anterior rectal resection.They were divided into no preventive stoma group(group A)and preventive stoma group,the preventive stoma group were divided into observation group(group B)and control group(group C),with no preventive stoma patients were supplied only laparoscopic rectal cancer radical surgery,control group patients were treated by preventive ileum stoma during the radical surgery.Patients in the observation group were treated with antegrade enema on the basis of the control group,20 cases in each group.By comparing the LARS score and Wexner score before surgery,1 month after surgery,3 months after surgery,and 6 months after surgery,the postoperative anorectal function of the 3 groups was prospectively evaluated.Results1.Complete data of 60 patients with rectal cancer were analyzed,there were no statistical differences in gender,age,educational level,working status,preoperative and postoperative chemoradiotherapy,besides postoperative tumor stage among the three groups(P > 0.05).The tumor distance from the anal margin in group A was farther than that in the other two groups,and there was no statistical difference between group B and group C.2.Preoperative and postoperative follow-up data: postoperative LARS score and Wexner score in group A were significantly better than those in the other two groups(P<0.05).LARS score and Wexner score in one,three and six months after surgery in the three groups gradually decreased(P<0.05).LARS score of group B was lower than that of group C three and six months after surgery(three months after surgery24.4±9.0 VS 34.3±4.2;six months after surgery 14.0±9.2 VS 22.0±9.5,P < 0.05);Wexner score of group B was lower than that of group C three and six months after surgery(three months afte=r surgery 5.0±2.7 VS 6.9±2.3;six months after surgery,2.3±1.8 VS 3.6±1.7,P < 0.05).ConclusionFor patients undergoing low anterior rectal resection,the incidence of postoperative low anterior resection syndrome is very highly and the recovery is slowly.Antegrade enema can effectively improve the postoperative anorectal function and improve the postoperative quality of life of the patients.