EVALUATING THE IMPACT OF ANUS-PRESERVING SURGERY ON POST-SURGICAL RECOVERY AND QUALITY OF LIFE IN ATHLETES WITH ULTRA-LOW RECTAL CANCER

Abstract

Background: This study evaluates the postoperative anal function and quality of life, focusing on athletes who have undergone anus-preserving surgery for ultra-low rectal cancer. This is particularly significant given the physical demands and recovery expectations unique to athletes. Methods: Between February 2017 and March 2019, 114 consecutive athletes diagnosed with ultra-low rectal cancer (T2 or higher) underwent one of three surgical procedures based on preoperative staging: ultra-low anterior resection (Dixon), modified coloanal anastomosis (modified Parks), or abdominoperineal resection (Miles). Postoperative anal function and Fecal Incontinence Quality of Life Scale (FIQL) scores were rigorously collected and analyzed to determine their recovery trajectory and readiness to return to athletic activities. Results: Initially, the Parks group showed significantly lower postoperative anal function and FIQL scores compared to the Dixon group. However, significant improvements were observed in the Parks group 6–12 months post-surgery, achieving levels comparable to the Dixon group (P > 0.05). Early postoperative FIQL scores for the Dixon and Parks groups were similar to those of the Miles group, but the Parks group demonstrated significantly improved scores in all FIQL categories 3-9 months post-surgery compared to the Miles group (P < 0.05). Conclusions: Laparoscopic modified Parks surgery is shown to be a safe, effective, and economical anus-preserving option for athletes with ultra-low rectal cancer. Although early postoperative outcomes were initially poorer compared to the Dixon procedure, they improved significantly over time, aligning closely with the athletes' requirements for returning to peak performance levels. This technique provides a beneficial alternative to the more invasive Miles’ operation, preserving the anus and significantly enhancing the quality of life and athletic performance post-surgery.