研究适形保肛术（CSPO）对低位直肠癌患者术后肛门功能的影响。

回顾性收集2020年1月至2023年9月200例低位直肠癌患者临床资料，根据不同的腹腔镜术式，分为A组（n=67，行CSPO），B组（n=83，行经括约肌间切除术），C组（n=50，行改良Bacon术）。采用SPSS 24.0软件处理数据，围手术期指标等计量资料用（±s）表示，多组间比较采用F检验；吻合口漏发生率等计数资料用[例(%)]表示，组间比较采用χ²检验；等级资料行秩和检验；以Kaplan-Meier法绘制患者术后12个月无病生存曲线，行Log-Rank检验。检验水准α=0.05。

所有患者无中转开腹手术病例，均行R0切除。三组患者淋巴结清扫数目、术后并发症Clavien-Dindo分级对比，差异无统计学意义（P>0.05）；A组患者手术、排气、下床活动、住院时间均短于B组、C组（P<0.05）；C组患者术中出血量少于A组、B组（P<0.05）；B组患者吻合口狭窄发生率显著高于A、C组（P<0.05）；C组患者吻合口漏发生率显著高于A、B组（P<0.05）。术前，三组患者生活质量评分比较，差异无统计学意义（P>0.05）；术后12个月，三组患者功能领域评分均较术前提高，症状领域评分下降，但A、C组改善优于B组（P<0.05）。术后12个月，A组、B组、C组无病生存期对比，差异无统计学意义（P>0.05）。

CSPO不仅能显著改善低位直肠癌患者术后肛门功能及长期生活质量，缩短手术时间，促进术后短期恢复，还能有效降低吻合口漏及吻合口狭窄的发生率。

To investigate the effect of conformal sphincter-preserving operation (CSPO) on postoperative anal function in patients with low rectal cancer.

Clinical data of 200 patients with low rectal cancer admitted to the hospital from January 2020 to September 2023 were retrospectively collected. According to different laparoscopic procedures, they were divided into group A (n=67, underwent conformal sphincter-preserving operation), group B (n=83, underwent intersphincteric resection), and group C (n=50, underwent modified Bacon procedure). SPSS 24.0 software was used for data processing. Measurement data such as perioperative indicators and quality of life scores were expressed as (±s), and multiple group comparisons were performed using F test. Enumeration data such as the incidence of anastomotic leakage and anastomotic stricture were expressed as [cases (%)], and intergroup comparisons were performed using chi-square test. Ranked data were expressed as the number of cases, and rank-sum test was used. Kaplan-Meier method was used to draw the disease-free survival curve at 12 months after surgery, and Log-Rank test was performed. The test level was α=0.05.

All patients had no conversion to open surgery and underwent R0 resection. There were no statistically significant differences in the number of lymph nodes dissected and Clavien-Dindo grade of postoperative complications among the three groups (P>0.05). The operation time, exhaust time, ambulation time, and hospital stay in group A were shorter than those in groups B and C (P<0.05). The intraoperative blood loss in group C was less than that in groups A and B (P<0.05). The incidence of anastomotic stricture in group B was significantly higher than that in groups A and C (P<0.05). The incidence of anastomotic leakage in group C was significantly higher than that in groups A and B (P<0.05). Before surgery, there was no statistically significant difference in quality of life scores among the three groups (P>0.05). At 12 months after surgery, the functional domain scores of the three groups were higher than those before surgery, and the symptom domain scores decreased, but the improvement in groups A and C was better than that in group B (P<0.05). There was no statistically significant difference in disease-free survival (DFS) among groups A, B, and C at 12 months after surgery (P>0.05).

CSPO can not only significantly improve the postoperative anal function and long-term quality of life of patients with low rectal cancer, shorten the operation time, and promote short-term postoperative recovery, but also effectively reduce the incidence of anastomotic leakage and anastomotic stricture.