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.