Analysis Of Related Factors Of Anterior Rectal Resection Syndrome After Resection Of Middle And Low Rectal Cancer

Objective:Anterior resection syndrome after rectal cancer surgery is a high complication rate after anus-preserving surgery for rectal cancer,which has an impact on the quality of life and psychology of patients.In this study,the risk factors of anterior rectotomy syndrome were analyzed retrospectively to provide references for clinical doctors in order to reduce the incidence of postoperative anterior rectotomy syndrome.Method:A retrospective analysis was performed on 179 patients with anus-preserving surgery for rectal cancer included in this study,91 patients without anterior rectotomy syndrome were included in the control group,88 patients with anterior rectotomy syndrome were included in the study group.In combination with relevant data,the following factors were collected and analyzed: sex,age,body mass index（BMI）,pre-operative complications,and pre-operative neoadjuvant therapy,the time of operation,the amount of blood lost during the operation,whether the left colonic artery was preserved,the distance between the anastomotic site and the anal border,whether a prophylactic stoma was performed,the anastomotic leakage after operation,the time of closing the stoma,the size of the tumor,the staging of the tumor,and the degree of differentiation.The factors of P < 0.05 in univariate analysis were analyzed by multiple Logistic regression,and the difference was statistically significant in P < 0.05.Result:In this study,the incidence of anterior rectotomy syndrome was 49.16%（88/179）.Among 88 LARS patients,the recovery time was 6 months and 12 months,and the number of cases of improvement was 36 and 64.Retrospective analysis of preoperative factors: sex,age,body mass index（BMI）,preoperative complications,preoperative whether new adjuvant treatment;Surgical related factors: operation time,intraoperative bleeding,whether to retain the left colonic artery,anastomotic distance from the anal margin,whether to carry out preventive stoma;Postoperative related factors: postoperative anastomotic leakage,including stoma time;tumor related factors: tumor size,tumor TNM stage,degree of differentiation.The results of univariate analysis and multivariate Logistic regression analysis showed that: Preoperative neoadjuvant therapy was performed and,the left colonic artery was completely ligation.Anastomosis distance from anal margin < 5cm;Postoperative anastomotic leakage is the risk factor for LARS of anterior rectal resection syndrome.Conclusion:Anterior rectal resection syndrome after anus-preserving surgery for rectal cancer is not caused by a single factor,but by a combination of factors.This study showed that preoperative neoadjuvant therapy,complete intraoperative ligation of the left colonic artery,and postoperative anastomotic leakage,less than 5cm from the anal margin were risk factors for LARS.Anterior rectal syndrome is a serious postoperative complication that affects the quality of life of patients.In view of the related risk factors,the clinician should pay attention to the functional protection while preserving the anus.