Anal function and quality of life analysis after laparoscopic modified Parks for ultra-low rectal cancer patients

Haibo Ding,Yuxiang Chen,Zhi Yang,Zha Peng,Xin Liao,Jian Li

doi:10.1186/s12957-020-1801-7

Abstract

BackgroundTo assess postoperative anal function and quality of life of ultra-low rectal cancer patients treated by laparoscopic modified Parks surgery.MethodsFrom February 2017 to March 2019, 114 patients with ultra-low rectal cancer above T2 were treated respectively with ultra-low anterior resection (Dixon), modified coloanal anastomosis (modified Parks), and Miles according to the preoperative stage and anastomotic position. The postoperative anal function and Fecal Incontinence Quality of Life Scale (FIQL) of each patient were collected and synthetically analyzed.ResultsCompared with the Dixon group, the postoperative anal function and FIQL in the Parks group were poor at the early stage. However, from 6 to 12 months after surgery, the scores of anal function and FIQL in the Parks group were similar to those in the Dixon group (P > 0.05). Compared with the Miles group, the FIQL of the two groups were similar in the early postoperative stage. However, with the passage of time, from 3 to 9 months after surgery, the four domains of FIQL in the Parks group were higher than those in the Miles group successively (P < 0.05).ConclusionsLaparoscopic modified Parks is a safe, effective, and economical anus-preserving surgery. Although its early anal function and FIQL were poor, it could gradually recover to the similar level as Dixon. Moreover, it can save the anus and obtain a better postoperative quality of life for some patients who previously could only undergo Miles.

Highlights

To assess postoperative anal function and quality of life of ultra-low rectal cancer patients treated by laparoscopic modified Parks surgery
There are few studies on anal function and quality of life after anus-preserving surgery, and most of them focus on patients undergoing intersphincteric resection (ISR) [23] and adjuvant radiotherapy and chemotherapy after ISR [24]
The results showed that the modified Parks surgery could achieve a good anal function and Fecal Incontinence Quality of Life Scale (FIQL) for patients with ultra-low rectal cancer while preserving the anus

Summary

Introduction

To assess postoperative anal function and quality of life of ultra-low rectal cancer patients treated by laparoscopic modified Parks surgery. In order to ensure radical treatment, for ultra-low rectal cancer within 5 cm from the lower edge of the tumor to the anus, it is considered that combined abdominal and perineal resection (APR), that is, Miles surgery, is the standard treatment [1]. Many related literatures have confirmed that 1 cm distal resection margin does not affect the oncological safety of rectal cancer [21, 22]. These studies and findings provide a theoretical basis for expanding the indications of anus-preserving surgery for ultra-low rectal cancer. There are few studies on anal function and quality of life after anus-preserving surgery, and most of them focus on patients undergoing intersphincteric resection (ISR) [23] and adjuvant radiotherapy and chemotherapy after ISR [24]

Methods

Results

Discussion

Conclusion