| Background and Objective Rectal cancer refers to cancer between the dentate line and the rectosigmoid junction,and is one of the most common malignant tumors in the digestive tract.Rectal cancer has a low position and is easily diagnosed by rectal examination and sigmoidoscopy.However,due to its location in the pelvic cavity,the anatomical relationship is complicated,the operation is not easy,and the recurrence rate is high.The lower middle rectal cancer is close to the anal sphincter.It is difficult to preserve the anus and its function during surgery.It is also a difficult problem in surgery.The ultra-low rectal cancer refers to the rectum ? 4cm away from the dentate line.cancer.In the past,the preferred surgical procedure for ultra-low rectal cancer is the Miles procedure,which is the combination of abdominal perineal and rectal cancer.With the aging of rectal cancer and the improvement of patients' quality of life,ultra-low rectal cancer anal sphincter surgery has become Research hotspots,and the need to protect the anal while protecting bowel movements,urination and sexual function are also getting higher and higher,the popularity of Total Mesorectal Exicision(TME)also promotes the development of anal sphincter preservation for ultra-low rectal cancer.This study aims to provide support for ultra-low rectal cancer anus-preserving surgery as a preferred procedure by comparing the survival time and quality of life of ultra-low rectal cancer with anal sphincter preservation and Miles procedure.Metheds In this study,76 patients with ultra-low rectal cancer admitted to the Department of Gastrointestinal Surgery of the Third Affiliated Hospital of Anhui Medical University were retrospectively studied.40 patients in the experimental group were treated with ultra-low anal sphincter preservation,and 36 patients in the control group were treated with traditional Miles.The procedure was selected from July 2012 to July 2015,including 29 males and 11 females in the experimental group,20 males and 16 females,aged 40-75 years,mean(61.9±6.4)years old.Patients who underwent stage II and III surgery were treated with XELOX regimen(oxaliplatin +capecitabine)6 times.Follow the patient or the patient's family by clinic or telephone to understand the patient's first and third year survival rates,and use the quality of life QOL score of the cancer patient to give the patient a quality of life in the first and third years after surgery.score.The survival time count data was analyzed by 2 test,the quality of life and other measurement data were expressed as mean ± standard deviation,and the t test was used to compare between the two groups.Result The survival rate of 40 patients with ultra-low position anus-preserving surgery was 39(survival rate of 97.5%),the quality of life in the first year was 43.7±3.8(min),and the number of survivors in the third year was 35(survival rate of 86.7%),the quality of life in the third year was scored 38.9 ± 2.5(minutes).Thirty-six patients who used the traditional Miles procedure had a first-year survival of 34(survival rate of 94.4%),a first-year quality of life score of 43.7 ± 3.8,and a third-year survival of31(survival rate of 86.1 %),the quality of life score for the third year was 27.5 ± 3.0.There was no significant difference in survival rate between the experimental group and the control group(P>0.05),but the quality of life score was significantly higher in the experimental group than in the control group,and the difference was statistically significant(P<0.05).Conclusion Ultra-low rectal cancer anal sphincter surgery can obtain satisfactory clinical results,and the postoperative survival rate of patients has no significant difference with traditional Miles,but the quality of life is significantly higher than traditional Miles.The two fundamental needs of patients,survival time and quality of life,improve the quality of life without reducing the survival time,so ultra-low rectal anal sphincter surgery is clinically feasible and preferential,but not blind The choice of anal sphincter surgery,in order to ensure the cure of the tumor,the pursuit of improved quality of life. |
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