Retrospective Analysis Study of Modified Bacon Procedure and Double Stapling Technique in Low Rectal Cancer Surgery

Abstract

Background

Sphincter-preserving surgery for low rectal cancer is challenging. The double stapling technique (DST) and modified Bacon procedure are commonly used, but their differences in postoperative functional recovery, complication rates, and survival outcomes have not been fully analyzed.

Methods

This retrospective cohort study included 110 patients who underwent low rectal cancer surgery from January 2018 to December 2022. Patients were divided into the modified Bacon procedure group (n = 43) and DST group (n = 67). Perioperative data, postoperative complications, Wexner scores, and three-year disease-free survival(DFS) and overall survival (OS) were collected and analyzed using R software.

Results

The modified Bacon procedure was associated with lower hospital costs (P = 0.009). Regarding postoperative complications, anastomotic leakage was significantly associated with the DST group (11.9% in the DST group vs 0% in the modified Bacon procedure group, P = 0.022), and prophylactic stoma use was significantly associated with a lower frequency in the modified Bacon procedure group (0% in the modified Bacon procedure group vs 19.4% in the DST group, P = 0.002). Higher Wexner scores at 3 and 6 months postoperatively were associated with the modified Bacon procedure (P < 0.001), but no significant association between surgical technique and Wexner scores was found at 12 months (P = 0.322). Survival analysis showed no significant association between surgical technique and DFS or OS, with parallel curves between the two groups.

Conclusion

The modified Bacon procedure may represent a feasible sphincter-preserving option for low rectal cancer, but its potential role requires further confirmation in prospective studies.

Keywords

rectal cancer modified bacon procedure double stapling technique functional recovery complications

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