我们的目的是进行倾向评分匹配研究，以比较括约肌间切除术与极低位吻合术低位前切除术（LAR）术后的长期功能结果和生活质量。接受括约肌间切除术或低位前切除术的患者回顾性纳入 2017 年 1 月至 2020 年 6 月期间因直肠癌进行的吻合术（距肛缘≤ 4 cm）。进行了倾向评分匹配过程。使用欧洲生活质量 5 维度 3 级别版本 (EQ-5D-3L)、EORC-QLQ C30、EORC-QLQ CR29、低位前切除综合征 (LARS)、Wexner 和国际前列腺评估功能结果和生活质量症状评分（IPSS）问卷。主要结果是术后至少 12 个月出现 LARS。第二个结局是纳入患者的术后生活质量。经过倾向匹配，共纳入128例患者，其中男性58例，女性70例，中位年龄59.5岁。括约肌间切除组的患者因排气失禁（32.8% vs 14.0%，p = 0.043）和大便失禁（42.2% vs 21.9%，p = 0.046）、疼痛/不适（25.0% vs 7.8%，p）的发生率较高。 = 0.001）和肠功能障碍，而两组的 LARS 评分（15.0 对比 13.2，p = 0.461）和主要 LARS 发生率（26.6% 对比 14.1%，p = 0.078）在两组中具有可比性。ISR 导致肠失禁率增加，增加肛门疼痛，但不影响低位前切除综合征、粪便紧迫性和聚集性的分级。当保证阴性切除边缘和安全吻合时，LAR 可能是首选的保留括约肌的方法。应充分告知患者保留括约肌手术后潜在的功能障碍。© 2023。Springer Nature Switzerland AG。

Our aim was to perform a propensity score-matched study to compare the long-term functional outcomes and quality of life following intersphincteric resection vs. low anterior resection (LAR) with very low anastomosis.Patients who underwent intersphincteric resection or low anterior resection with low anastomosis (≤ 4 cm from the anal verge) for rectal cancer between January 2017 and June 2020 were retrospectively included. A propensity score-matching process was performed. Functional outcomes and quality of life were assessed using the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L), EORC-QLQ C30, EORC-QLQ CR29, Low Anterior Resection Syndrome (LARS), Wexner, and International Prostate Symptom Score (IPSS) questionnaires. The primary outcome was the presence of LARS at least 12 months after surgery. The second outcome was the postoperative quality of life of included patients.After propensity matching, 128 patients were included, including 58 males and 70 females with a median age of 59.5. Patients in the intersphincteric resection group showed a higher incidence of incontinence to flatus (32.8% versus 14.0%, p = 0.043) and stools (42.2% versus 21.9%, p = 0.046), pain/discomfort (25.0% versus 7.8%, p = 0.001), and bowel dysfunction, while the LARS scores (15.0 versus 13.2, p = 0.461) and major LARS rates (26.6% versus 14.1%, p = 0.078) were comparable in both groups.ISR leads to increased bowel incontinence rate and increased anal pain, without affecting the grade of low anterior resection syndrome, fecal urgency, and clustering. LAR might be the preferred sphincteric-preserving approach when negative resection margins and a safe anastomosis are guaranteed. Patients should be fully informed about potential functional impairment after sphincter-preservation procedures.© 2023. Springer Nature Switzerland AG.