Assessment of the relation between the distal resection margin and incidence of local recurrence after low anterior resection in cases of low rectal cancer

Introduction One of the world's major causes of death and morbidity is colorectal cancer. It is the world's third most frequent cancer and the fourth biggest cause of cancer-related deaths, with an estimated 1 400 000 new cases and 700 000 fatalities per year. The distal resection margin is crucial in rectal cancer surgery. Surgeons in the colorectal field are frequently different between keeping an oncologically safe margin and attempting sphincter-preservation surgery. The goal of this study was to determine the oncological safety of a modest distal resection margin. Patients and methods This is a study that looks backward in time. We gathered patient data from Ain Shams University hospitals' colorectal and oncology departments. Patients who had a low anterior resection between January 2015 and January 2019 were included in this study. Results We found that distance of distal free margin, number of positive lymph node, and number of dissected lymph node were not significantly associated with recurrence, but response to neoadjuvant chemotherapy was associated with lower recurrence rate. Distal free margin was achieved in 98% of our patients, but we had one patient with infiltrated margin who had completed abdominoperineal resection. There was a discrepancy in the distance of the distal free margin and the existence of prior chemotherapy or radiotherapy among studies of low anterior resection of rectal cancer. Conclusion In our research, we discovered that while a free distal margin is required in rectal cancer resection, there is no link between the distance of the free distal margin and local recurrence. We also discovered that lymphovascular invasion and responsiveness to neoadjuvant chemoradiation have a substantial impact on rectal cancer local recurrence rates.