Comparison of anal function and quality of life after conformal sphincter preservation operation and intersphincteric resection of very low rectal cancer - a multicenter retrospective case-control analysis

Q: What was the purpose of comparing CSPO and ISR?

To compare postoperative anal function and quality of life between conformal sphincter preservation operation (CSPO) and intersphincteric resection (ISR) in patients with very low rectal cancer.

Q: How were anal function and quality of life measured?

Anal satisfaction was evaluated with a visual analog scale, and anal function was assessed using Wexner and LARS scores. Quality of life was evaluated with EORTC QLQ-C30 and QLQ-CR38.

Q: What did the results show about CSPO compared with ISR?

CSPO was associated with higher satisfaction with anal function and quality of life, while not significantly improving Wexner, LARS, or some EORTC quality-of-life scales. CSPO patients required more preoperative chemoradiotherapy.

Sep 24, 2026

Uploaded by Jasmine

The study compares postoperative anal function and quality of life between conformal sphincter preservation operation (CSPO) and intersphincteric resection (ISR) for very low rectal cancer. Patients undergoing CSPO (n=117) and ISR (n=66) were retrospectively collected from Changhai and Huashan Hospitals between 2011 and 2020. Anal satisfaction and function were assessed with visual analog scale, Wexner, and LARS, while quality of life used EORTC QLQ-C30 and QLQ-CR38. CSPO improved satisfaction and quality-of-life outcomes but involved more preoperative chemoradiotherapy, suggesting CSPO as an alternative option for patients prioritizing anal function and life quality.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

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Abstract

Introduction

Patients and methods

Patient selection

Keywords

Techniques in Coloproctology (2023) 27:1275–1287 [https://doi.org/10.1007/s10151-023-02819-w](https://doi.org/10.1007/s10151-023-02819-w) Comparison of anal function and quality of life after conformal sphincter preservation operation and intersphincteric resection of very low rectal cancer: a multicenter, retrospective, case–control analysis G. Sun1,3 · Y. Zang2 · H. Ding1 · Y. Chen4 · D. Groothof5 · H. Gong1 · Z. Lou1 · R. Meng1 · Z. Chen2 · E. Furnee3 · J. Xiang2 · W. Zhang1 Received: 1 January 2023 / Accepted: 2 May 2023 / Published online: 29 May 2023 © The Author(s) 2023 Abstract Purpose Conformal sphincter preservation operation (CSPO) is a sphincter preservation operation for very low rectal cancers. Compared to intersphincteric resection (ISR), CSPO retains more dentate line and distal rectal wall, and also avoids damaging the nerves in the intersphincteric space. This study aimed to compare the postoperative anal function and quality of life between the CSPO and ISR. Method Patients with low rectal cancer undergoing CSPO (n = 117) and ISR (n = 66) were included from Changhai and Huashan Hospital, respectively, between 2011 and 2020. A visual analog scale (range 0–10) was utilized to evaluate satisfaction with anal function and quality of life. The anal function was evaluated with Wexner scores and low anterior resection syndrome (LARS) score. Quality of life was evaluated with the EORTC QLQ-C30 and QLQ-CR38 . Results The CSPO group had more male patients (65.8% vs. 50%, p = 0.042), more preoperative chemoradiotherapy (33.3% vs. 10.6%, p < 0.001), lower tumor position (3.45 ± 1.13 vs. 4.24 ± 0.86 cm, p < 0.001), and more postoperative chemotherapy (65% vs. 13.6%, p < 0.001) compared to the ISR group. In addition, CSPO patients had shorter postoperative stay (6.63 ± 2.53 vs. 7.85 ± 4.73 days, p = 0.003) and comparable stoma reversal rates within 1 year after surgery (92.16% vs. 96.97%, p = 0.318) . Multivariable analysis showed that CSPO significantly contributed to higher satisfaction with anal function (beta = 1.752, 95% CI 0.776–2.728) and with quality of life (beta = 1.219, 95% CI 0.374–2.064), but not to Wexner, LARS score, or EORTC QLQ-C30 and QLQ-CR38 . Conclusion CSPO improved the satisfaction with anal function and quality of life but utilized more preoperative chemoradiotherapy. CSPO may be an alternative choice for patients with very low rectal cancers in better physical health and with higher requirements for anal function and quality of life. Keywords Conformal sphincter preservation operation · Intersphincteric resection · Anal function · Quality of life · Very low rectal cancer · Outcome Ge Sun, Yiwen Zang, and Haibo Ding contributed equally. * J. Xiang [xjbzhw@163.com](xjbzhw@163.com) * W. Zhang [weizhang2000cn@163.com](weizhang2000cn@163.com) 1 Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangpu District, Shanghai 200433, China 2 Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China 3 Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands 4 Department of Epidemiology and Public Health, University College London, London, UK 5 Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands Introduction Intersphincteric resection (ISR) is a sphincter preservation operation for very low rectal cancers. However, according to the literature and our experience with ISR, patients often have poor postoperative anal function, leading to decreased quality of life. This might be due to partial or total resection of the internal anal sphincter and dentate line, but also due to damaging the autonomic nerves during extensive dissection in the sphincteric space [1–3] . To improve postoperative anal function for patients with very low rectal cancer, we designed the conformal sphincter preservation operation (CSPO) . CSPO retains

FAQs

What was the purpose of comparing CSPO and ISR?

To compare postoperative anal function and quality of life between conformal sphincter preservation operation (CSPO) and intersphincteric resection (ISR) in patients with very low rectal cancer.

How were anal function and quality of life measured?

Anal satisfaction was evaluated with a visual analog scale, and anal function was assessed using Wexner and LARS scores. Quality of life was evaluated with EORTC QLQ-C30 and QLQ-CR38.

What did the results show about CSPO compared with ISR?

CSPO was associated with higher satisfaction with anal function and quality of life, while not significantly improving Wexner, LARS, or some EORTC quality-of-life scales. CSPO patients required more preoperative chemoradiotherapy.

Sep 24, 2026

Uploaded by Jasmine