Functional Outcomes and Patient Satisfaction after Abdominoperineal Resection versus Sphincter-Preserving Techniques for Low Rectal Cancer: A Retrospective Single-Centre Study.

In rectal cancer surgery, maintaining a balance between oncologic control and postoperative quality of life is critical. Sphincter-preserving procedures may offer better functional outcomes, but results vary depending on the technique used. This retrospective, observational, single-center study included 62 patients with adenocarcinoma of the rectum 5 cm from the anal verge, operated between August 2022 and August 2024. All received standard neoadjuvant therapy. Patients underwent one of three procedures: abdominoperineal resection, standard coloanal anastomosis, or delayed coloanal anastomosis (Turnbull-Cutait). Functional outcomes were assessed using LARS and St Marks scores at 1, 6, and 12 months postoperatively. Satisfaction was evaluated via telephone interviews. Seventeen patients underwent abdominoperineal resection, 10 received standard coloanal anastomosis, and 35 underwent the delayed technique. Standard anastomosis yielded significantly better continence scores than the Turnbull-Cutait group. Patients with abdominoperineal resection had higher rates of pulmonary complications and prolonged inflammation. At one year, 80% of patients reported satisfaction with the procedure. Conclusion: All techniques can provide high satisfaction, but standard coloanal anastomosis appears to offer superior functional outcomes. Surgical decision-making should be individualized and based on thorough informed consent.