Influencing Factors of Surgical Difficulty in the Treatment of Low Rectal Cancer with Internal Sphincterotomy

Liu Ziming

doi:10.3969/j.issn.1004-5775.2025.13.012

Abstract：Objective:To explore the influencing factors of surgical difficulty in the treatment of low rectal cancer(LRC)with internal sphincterotomy(ISR).Methods:102 LRC patients who were underwent ISR treatment in Shenqiu County People's Hospital from May 2021 to May 2023 were selected.The surgical difficulty was analyzed.Univariate analysis and logistic multiple regression analysis were conducted to identify the influencing factors of ISR treatment for LRC surgical difficulty.Results:Among the 102 patients,24 cases were found to be difficult to perform surgery,78 cases were found to be easy to perform surgery.The proportion of obesity,maximum tumor diameter≥40 mm,distance between tumor and anal margin≤2.5 cm,distance between ischial nodules≤10 cm,and rectal mesenteric fat area≥22 cm2 of the difficult group were higher than those in the easy group(χ2=5.976,6.473,4.302,9.086,4.797;P＜0.05).The results of logistic multiple regression analysis showed that obesity,maximum tumor diameter≥40mm,distance from the tumor to the anal margin≤2.5 cm,distance between ischial nodules≤10 cm and mesorectal fat area≥22 cm2 were independent risk factors affecting the difficulty of ISR treatment for LRC(OR=11.568,11.218,0.442,0.365,1.789;P＜0.05).Conclusion:ISR treatment for LRC surgery has certain difficulties,which are related to obesity,the maximum diameter of the tumor,the distance between the tumor and the anal margin,the distance between ischial nodules,and the area of mesorectal fat.Targeted interventions are needed to reduce the surgical difficulty.