Study On The Correlation Between The Postoperative Pelvic Floor Structural Changes And Anterior Resection Syndrome For Low Rectal Cancer

Objective: There are individual differences in the recovery of anorectal function in patients with low rectal cancer after anus preservation surgery.This article aims to explore and analyze the relationship between postoperative pelvic floor structural changes in patients with low rectal cancer and low anterior resection syndrome(LARS)Clinical factors,in order to have a deeper understanding of the causes of LARS to facilitate individualized treatment of patients with LARS.Subjects and methods: A retrospective analysis of the clinical data of 81 patients with low rectal cancer who underwent surgical treatment at the Colorectal and Anal Surgery Department of the Guangxi Institute of Cancer Prevention and Treatment in Guangxi Zhuang Autonomous Region from March2019 to April 2020.All patients completed the preoperative imaging examination and obtained pathological diagnosis.The patients with low rectal cancer received adjuvant radiotherapy and chemotherapy first,and then returned to the hospital for surgical treatment after 8 weeks of radiotherapy.After the operation,the patients’ living conditions were followed up dynamically and returned to the hospital regularly for abdominal imaging diagnostic examinations and anal pressure testing to assess anorectal function.Single factor analysis and multiple factor analysis were used to study various clinical factors and their correlations that affect postoperative anorectal function.Results: one year after operation,anorectal function improved in 74 cases(740.81%).The results of univariate analysis of LARS score showed that the coefficient of intestinal adhesion K,thickness of the rectum anterior sacral space and position of anastomosis were K,0.004 and 0.037,respectively.In rectal RC,the coefficient of adhesion K(0.013),the rectum anterior sacral space(0.012),position of anastomosis(0.032)and age(0.048)were correlated with anorectal function.Combined with the two data,the adhesion coefficient K,thickness of the rectum anterior sacral space and position of anastomosis were related to anorectal function.The multivariate results showed that the rectum anterior sacral space thickness(OR=1.894,P=0.006)and adhesion coefficient K value(OR=15.69,P=0.001)were classified as LARS score.When rectal RC was used as evaluation index,the change of the rectum anterior sacral space thickness(OR=1.074,P=0.088),adhesion coefficient K value(OR=15.69,P=0.002)and anastomotic position(OR=0.23,P=0.045)were determined.Combining the data of the two evaluation indexes,it is suggested that the thickness of the rectum anterior sacral space and K value of adhesion coefficient are important factors affecting postoperative anorectal function.Conclusion: the change of pelvic floor structure caused by the change of adhesion coefficient K and the thickness of the rectum anterior sacral space after operation of low rectal cancer is an important factor affecting anorectal function.The growth of perisacral adipose tissue and the thickness of the rectum anterior sacral space can be restored to the original pelvic floor structure to some extent to avoid direct adhesion between the intestine and the wall,which is helpful to improve the symptoms of postoperative LARS and improve the quality of life of patients.