关键词: 改良Bacon术, 低位前切除术, 中低位直肠癌, 术后并发症

Abstract: Objective To explore the clinical efficacy of the modified Bacon procedure and low anterior resection in the treatment of patients with middle and low rectal cancer.Methods A retrospective analysis was conducted on the clinical data of 130 patients with mid to low rectal cancer who underwent surgical treatment in the Colorectal and Anal Surgery Department of our hospital from January 2023 to December 2024.They were divided into Group A (laparoscopic anterior resection group,109 cases) and Group B (laparoscopic modified Bacon surgery group,21 cases) according to different anastomosis methods.The baseline data,surgical related indicators,postoperative pathological related indicators,and postoperative recovery of the two groups of patients were compared.The recovery function of the anus of the postoperative patients was evaluated by using the LARS scoring scale and the Wexner scoring scale at 1,3,6,9 and 12 months after the operation respectively.Results There was no statistically significant difference (P>0.05) between the two groups of patients in terms of surgical time,intraoperative blood loss,tumor gross classification,tumor circumferential length,and postoperative complications at 30 days.The distances from the lower edge of the tumor to the dentate line in group A and group B were (5.31±1.21)cm and (2.41±0.65)cm,respectively.The proportions of patients with stage T3-T4 tumors were 80% and 57%,respectively.The lengths of hospital stay were (9.35±4.83) days and (21.38±4.33) days,respectively.There was a statistically significant difference between the two groups (P<0.05).The incidences of severe LARS in group A and group B at 1 month,3 months and 6 months after surgery were 54% and 86%,41% and 76%,27% and 62%,respectively,and the Wexner scores were (10.12±2.01) points and (14.57±2.39) points,(7.05±1.33) points and (9.71±1.58) points,(3.23±1.24) points and (5.43±1.66) points,respectively.There was a statistically significant difference between the two groups (P<0.05).There was no significant statistical difference in the incidence of severe LARS and Wexner score between the two groups of patients at 9 and 12 months after surgery (P>0.05).Conclusion Compared with traditional low anterior resection,the modified Bacon procedure does not significantly increase early postoperative complications,and postoperative anal function is not inferior to that of patients undergoing low anterior resection.

Key words: improved Bacon procedure, low anterior resection, middle-low rectal cancer, postoperative complications