{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T14:19:23Z","timestamp":1762352363007,"version":"3.41.0"},"reference-count":28,"publisher":"International College of Surgeons","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014]]},"abstract":"Abstract<\/jats:title>\n Abdominoperineal resection (APR) and sphincter-preserving resection (SPR) are the two primary surgical options for rectal cancer. Retrospectively we collected rectal cancer patients for SPR and APR observation between 2005 and 2007. The patient-related, tumor-related, and surgery-related variables of the SPR and APR groups were analyzed by using logistic regression techniques. The mean distance from the anal verge (DAV) of cancer is significantly higher in SPR than that in APR (P<\/jats:italic> < 0.001). In cancers with DAV <40 mm (SPR, 40 versus APR, 110), multivariate analysis shows that surgeon procedure volume (odds ratio [OR] = 0.244; 95% confidence interval [CI]: 0.077\u20130.772; P<\/jats:italic> = 0.016) and neoadjuvant radiotherapy (OR = 0.031; 95% CI: 0.002\u20130.396; P<\/jats:italic> = 0.008) are factors influencing SPR. In cancers with DAV ranging from 40 mm to 59 mm (SPR 190 versus APR 50), analysis shows that patient age (OR = 2.139; 95% CI: 1.124\u20134.069; P<\/jats:italic> = 0.021), diabetes (OR = 2.657; 95% CI: 0.872\u20138.095; P<\/jats:italic> = 0.086), and colorectal surgeon (OR = 0.122, 95% CI: 0.020\u20130.758; P<\/jats:italic> = 0.024), are influencing factors for SPR. The local recurrence and disease-free survival reveal no significant difference. A significant difference exists in DAV, surgeon specialization, procedure volume, age, diabetes, and neoadjuvant radiotherapy between SPR and APR.<\/jats:p>","DOI":"10.9738\/intsurg-d-13-00217.1","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T19:24:38Z","timestamp":1406229878000},"page":"330-337","source":"Crossref","is-referenced-by-count":12,"title":["Risk Factors Associated With Sphincter-Preserving Resection in Patients With Low Rectal Cancer"],"prefix":"10.9738","volume":"99","author":[{"given":"Zhi-Jie","family":"Cong","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China."},{"name":"Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang-Hao","family":"Hu","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Jie","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan-Gang","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"En-Da","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"2","key":"i0020-8868-99-4-330-b01","series-title":"Ann Surg","first-page":"260","article-title":"Factors associated with sphincter-preserving surgery for rectal cancer at national comprehensive cancer network centers","volume":"250","author":"Temple\n LK,","year":"2009","unstructured":"Temple\n LK, \n \n Romanus\n D, \n \n Niland\n J, \n \n Veer\n AT, \n \n Weiser\n MR, \n \n Skibber\n J\n \n et al\n . Factors associated with sphincter-preserving surgery for rectal cancer at national comprehensive cancer network centers. Ann Surg2009;250(2):260\u2013267"},{"issue":"2","key":"i0020-8868-99-4-330-b02","series-title":"Am J Surg","first-page":"239","article-title":"Prognostic factors and preoperative radiation therapy associated with sphincter preservation in patients with resectable rectal cancer","volume":"195","author":"Howard\n JH,","year":"2008","unstructured":"Howard\n JH, \n \n Gonzalez\n Q, \n \n Arnoletti\n JP, \n \n Russo\n S, \n \n Fiveash\n JB, \n \n Bland\n KI\n \n et al\n . Prognostic factors and preoperative radiation therapy associated with sphincter preservation in patients with resectable rectal cancer. Am J Surg2008;195(2):239\u2013243"},{"issue":"2","key":"i0020-8868-99-4-330-b03","series-title":"Dis Colon Rectum","first-page":"115","article-title":"Patient and hospital factors associated with use of sphincter-sparing surgery for rectal cancer","volume":"53","author":"Paquette\n IM,","year":"2010","unstructured":"Paquette\n IM, \n \n Kemp\n JA, \n \n Finlayson\n SR. \n \n Patient and hospital factors associated with use of sphincter-sparing surgery for rectal cancer. Dis Colon Rectum2010;53(2):115\u20131120"},{"issue":"6\u20137","key":"i0020-8868-99-4-330-b04","series-title":"G Chir","first-page":"253","article-title":"Total mesorectal excision. The new European gold standard","volume":"19","author":"Heald\n RJ.","year":"1998","unstructured":"Heald\n RJ. \n \n Total mesorectal excision. The new European gold standard. 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Ann Surg2007;246(2):207\u2013214"},{"issue":"1","key":"i0020-8868-99-4-330-b14","series-title":"Ann Surg","first-page":"52","article-title":"Systematic review and meta-analysis of the role of defunctioning stoma in low rectal cancer surgery","volume":"248","author":"Huser\n N,","year":"2008","unstructured":"Huser\n N, \n \n Michalski\n CW, \n \n Erkan\n M, \n \n Schuster\n T, \n \n Rosenberg\n R, \n \n Kleeff\n J\n \n et al\n . Systematic review and meta-analysis of the role of defunctioning stoma in low rectal cancer surgery. Ann Surg2008;248(1):52\u201360"},{"issue":"4","key":"i0020-8868-99-4-330-b15","series-title":"Dis Colon Rectum","first-page":"459","article-title":"Early results of intersphincteric resection for patients with very low rectal cancer: an active approach to avoid a permanent colostomy","volume":"47","author":"Saito\n N,","year":"2004","unstructured":"Saito\n N, \n \n Ono\n M, \n \n Sugito\n M, \n \n Ito\n M, \n \n Morihiro\n M, \n \n Kosugi\n C\n \n et al\n . 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Dis Colon Rectum2005;48(2):195\u2013202; discussion 202\u2013204"},{"issue":"5","key":"i0020-8868-99-4-330-b20","series-title":"Br J Surg","first-page":"657","article-title":"Influence of hospital- and surgeon-related factors on outcome after treatment of rectal cancer with or without preoperative radiotherapy","volume":"84","author":"Holm\n T,","year":"1997","unstructured":"Holm\n T, \n \n Johansson\n H, \n \n Cedermark\n B, \n \n Ekelund\n G, \n \n Rutqvist\n LE. \n \n Influence of hospital- and surgeon-related factors on outcome after treatment of rectal cancer with or without preoperative radiotherapy. Br J Surg1997;84(5):657\u2013663"},{"issue":"6","key":"i0020-8868-99-4-330-b21","series-title":"Med J Aust","first-page":"308","article-title":"Colorectal cancer: is the surgeon a prognostic factor? A systematic review","volume":"171","author":"Meagher\n AP.","year":"1999","unstructured":"Meagher\n AP. \n \n Colorectal cancer: is the surgeon a prognostic factor? A systematic review. Med J Aust1999;171(6):308\u2013310"},{"issue":"2","key":"i0020-8868-99-4-330-b22","series-title":"Am J Surg","first-page":"92","article-title":"Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision","volume":"179","author":"Law\n WI,","year":"2000","unstructured":"Law\n WI, \n \n Chu\n KW, \n \n Ho\n JW, \n \n Chan\n CW. \n \n Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision. Am J Surg2000;179(2):92\u201396"},{"issue":"5","key":"i0020-8868-99-4-330-b23","series-title":"Eur J Oncol Nurs","first-page":"409","article-title":"Information needs and decision-making preferences: comparing findings for gynaecological, breast and colorectal cancer","volume":"11","author":"Beaver\n K,","year":"2007","unstructured":"Beaver\n K, \n \n Booth\n K. \n \n Information needs and decision-making preferences: comparing findings for gynaecological, breast and colorectal cancer. Eur J Oncol Nurs2007;11(5):409\u2013416"},{"issue":"2","key":"i0020-8868-99-4-330-b24","series-title":"Int J Radiat Oncol Biol Phys","first-page":"e165","article-title":"Correlation in rectal cancer between clinical tumor response after neoadjuvant radiotherapy and sphincter or organ preservation: 10-year results of the Lyon R 96-02 randomized trial","volume":"83","author":"Ortholan\n C,","year":"2012","unstructured":"Ortholan\n C, \n \n Romestaing\n P, \n \n Chapet\n O, \n \n Gerard\n JP. \n \n Correlation in rectal cancer between clinical tumor response after neoadjuvant radiotherapy and sphincter or organ preservation: 10-year results of the Lyon R 96-02 randomized trial. Int J Radiat Oncol Biol Phys2012;83(2):e165\u2013e171"},{"issue":"2","key":"i0020-8868-99-4-330-b25","series-title":"Ann Surg","first-page":"236","article-title":"Sphincter preservation in low rectal cancer is facilitated by preoperative chemoradiation and intersphincteric dissection","volume":"249","author":"Weiser\n MR,","year":"2009","unstructured":"Weiser\n MR, \n \n Quah\n HM, \n \n Shia\n J, \n \n Guillem\n JG, \n \n Paty\n PB, \n \n Temple\n LK\n \n et al\n . Sphincter preservation in low rectal cancer is facilitated by preoperative chemoradiation and intersphincteric dissection. 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Cancer2003;97(2):517\u2013524"},{"issue":"9","key":"i0020-8868-99-4-330-b27","series-title":"N Engl J Med","first-page":"638","article-title":"Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer","volume":"345","author":"Kapiteijn\n E,","year":"2001","unstructured":"Kapiteijn\n E, \n \n Marijnen\n CA, \n \n Nagtegaal\n ID, \n \n Putter\n H, \n \n Steup\n WH, \n \n Wiggers\n T\n \n et al\n . Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med2001;345(9):638\u2013646"},{"issue":"4","key":"i0020-8868-99-4-330-b28","series-title":"Am J Surg","first-page":"508","article-title":"Damage to anal sphincter\/levator ani muscles caused by operative procedure in anal sphincter-preserving operation for rectal cancer","volume":"201","author":"Hirano\n A,","year":"2011","unstructured":"Hirano\n A, \n \n Koda\n K, \n \n Kosugi\n C, \n \n Yamazaki\n M, \n \n Yasuda\n H. \n \n Damage to anal sphincter\/levator ani muscles caused by operative procedure in anal sphincter-preserving operation for rectal cancer. 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