Influences of Dixon anus preserving surgery on curative effect, anorectal function and stress response in patients with low rectal cancer / 中国医师进修杂志

ABSTRACT

Objective:To investigate the influences of Dixon anus preserving surgery on the curative effect, anorectal function and stress response of patients with low rectal cancer.Methods:A total of 150 patients with low rectal cancer admitted to Zhangjiakou Fifth Hospital from May 2016 to March 2019 were retrospective analysis as the study subjects. According to the different surgical methods, the patients were divided into the study group (75 cases) and the control group (75 cases). The patients in the study group received Dixon operation, and the patients in the control group received Miles operation. The general condition of operation, postoperative urination function, stress response [C reactive protein (CRP), interleukin-6 (IL-6), cortisol (Cor) and adrenocorticotropic hormone (ACTH)], anorectal function [anal resting pressure (ARP), maximal squeeze pressure (MSP), anal longest contraction time (ALCT)], quality of life (PAC-QOL score), postoperative complications, local recurrence rate, distant metastasis rate, 3-year tumor free survival rate and 3-year overall survival rate were compared between the two groups.Results:The operation time, intraoperative blood loss and postoperative drainage volume in the study group were lower than those in the control group: (172.28 ± 23.45) min vs. (189.57 ± 23.68) min, (177.39 ± 21.23) ml vs. (191.35 ± 22.67) ml, (342.36 ± 52.89) ml vs. (489.42 ± 63.33) ml, there were statistical differences ( P<0.05). The levels of CRP, IL-6, Cor and ACTH in the study group were lower than those in the control group: (22.35 ± 4.75) mg/L vs. (35.65 ± 5.28) mg/L, (58.74 ± 15.11) μg/L vs. (79.63 ± 20.23) μg/L, (145.36 ± 27.48) ng/L vs. (156.48 ± 32.55) ng/L, (44.58 ± 5.27) ng/L vs. (49.62 ± 5.68) ng/L, there were statistical differences ( P<0.05). The urination function and anorectal function of the patients in the study group were obviously better than those in the control group 6 months after operation, and the PAC-QOL score was obviously lower than that in the control group: (22.53 ± 2.86) scores vs. (27.54 ± 3.21) scores ( P<0.05); there was no obvious difference between the study group and the control group in the incidence of postoperative complications, local recurrence rate, distant metastasis rate, 3-year tumor free survival rate and 3-year total survival rate ( P>0.05). Conclusions:Dixon operation is effective in the treatment of low rectal cancer. It can preserve the anorectal function of patients to the greatest extent, protect urination function, reduce stress reaction of patients, and it is more conducive to rapid rehabilitation of patients.