Objective:To compare bowel function 12 months after surgery between side-to-end anastomosis (SEA) and end-to-end anastomosis (EEA) groups of patients who had undergone rectal cancer resection.Methods:This single-center, prospective, open-label, phase III randomized controlled trial was approved by the Ethics Committee of Peking University People's Hospital (2018PHB040-01) and registered at ClinicalTrials. org (NCT03669237). Inclusion criteria were as follows: (1) histologically confirmed rectal adenocarcinoma; (2) tumor located 0 to 12 cm from the anal verge; (3) age≥18 years; and (4) planned R0 resection with primary reconstruction. Exclusion criteria included: (1) emergency surgery; (2) cognitive impairment; (3) non-primary anastomosis; (4) history of left-sided colonic or anorectal surgery; and (5) preexisting chronic defecation dysfunction. Eligible rectal cancer patients scheduled for elective sphincter-preserving surgery at Peking University People's Hospital were prospectively enrolled between October 2018 and March 2021 and randomly assigned to either the EEA group or the SEA group via computer-generated numbers prior to entering the operating room. All patients underwent standard radical tumor resection. Bowel function was evaluated by the low anterior resection syndrome (LARS) questionnaire. It consists of five single-choice questions and yields a total score ranging from 0 to 42. Defecation function is categorized into three levels: no LARS (0-20 points), minor LARS (21-29 points), and major LARS (30-42 points). The primary endpoint was the LARS score 12 months after surgery. Secondary endpoints included LARS scores from 1 to 11 months and during long-term follow-up(>12 months). The final follow-up was completed in July 2022. All randomized patients were included in the intention-to-treat set (ITTS). The full analysis set (FAS) was defined as ITTS patients with valid outcome data. All primary statistical analyses were performed in the FAS, and results were further compared in the per-protocol set (PPS) based on the actual treatment received.Results:A total of 323 patients underwent eligibility assessment, of whom 71 did not meet the inclusion criteria and 52 declined to participate. Ultimately, 200 patients were randomized. Median age was 64 years and 85 were women. The SEA and EEA groups comprised 102 and 98 patients, respectively. A total of 181 patients (90.5%) were included in the FAS, and 170 (85.0%) were included in the PPS. Among these, the 12-month LARS score was evaluated in 178 patients (98.3%) in the FAS and in 167 (98.2%) in the PPS. Median LARS score at 1–12 months were significantly lower in the SEA group in both the FAS dataset [12 months:8 (interquartile range [IQR], 0–22) vs. 14 (IQR, 8–29); Z=2.687, P=0.007] and the PPS dataset [12 months: 8 (IQR, 0–22) vs. 14 (IQR, 6–29); Z=2.543, P=0.011]. During long-term follow-up, the median LARS score was also significantly lower in the SEA group in the FAS dataset [2 (IQR, 0–4) vs. 11 (IQR, 2–23); Z=2.968, P=0.003] and the PPS dataset [2 (IQR, 0–14) vs. 11 (2, 27); Z=2.687, P=0.007]. Conclusion:Compared with the EEA group, bowel function was superior in the SEA group 1 year after surgery and during long-term follow-up.

Objective:To compare bowel function 12 months after surgery between side-to-end anastomosis (SEA) and end-to-end anastomosis (EEA) groups of patients who had undergone rectal cancer resection.Methods:This single-center, prospective, open-label, phase III randomized controlled trial was approved by the Ethics Committee of Peking University People's Hospital (2018PHB040-01) and registered at ClinicalTrials. org (NCT03669237). Inclusion criteria were as follows: (1) histologically confirmed rectal adenocarcinoma; (2) tumor located 0 to 12 cm from the anal verge; (3) age≥18 years; and (4) planned R0 resection with primary reconstruction. Exclusion criteria included: (1) emergency surgery; (2) cognitive impairment; (3) non-primary anastomosis; (4) history of left-sided colonic or anorectal surgery; and (5) preexisting chronic defecation dysfunction. Eligible rectal cancer patients scheduled for elective sphincter-preserving surgery at Peking University People's Hospital were prospectively enrolled between October 2018 and March 2021 and randomly assigned to either the EEA group or the SEA group via computer-generated numbers prior to entering the operating room. All patients underwent standard radical tumor resection. Bowel function was evaluated by the low anterior resection syndrome (LARS) questionnaire. It consists of five single-choice questions and yields a total score ranging from 0 to 42. Defecation function is categorized into three levels: no LARS (0-20 points), minor LARS (21-29 points), and major LARS (30-42 points). The primary endpoint was the LARS score 12 months after surgery. Secondary endpoints included LARS scores from 1 to 11 months and during long-term follow-up(>12 months). The final follow-up was completed in July 2022. All randomized patients were included in the intention-to-treat set (ITTS). The full analysis set (FAS) was defined as ITTS patients with valid outcome data. All primary statistical analyses were performed in the FAS, and results were further compared in the per-protocol set (PPS) based on the actual treatment received.Results:A total of 323 patients underwent eligibility assessment, of whom 71 did not meet the inclusion criteria and 52 declined to participate. Ultimately, 200 patients were randomized. Median age was 64 years and 85 were women. The SEA and EEA groups comprised 102 and 98 patients, respectively. A total of 181 patients (90.5%) were included in the FAS, and 170 (85.0%) were included in the PPS. Among these, the 12-month LARS score was evaluated in 178 patients (98.3%) in the FAS and in 167 (98.2%) in the PPS. Median LARS score at 1–12 months were significantly lower in the SEA group in both the FAS dataset [12 months:8 (interquartile range [IQR], 0–22) vs. 14 (IQR, 8–29); Z=2.687, P=0.007] and the PPS dataset [12 months: 8 (IQR, 0–22) vs. 14 (IQR, 6–29); Z=2.543, P=0.011]. During long-term follow-up, the median LARS score was also significantly lower in the SEA group in the FAS dataset [2 (IQR, 0–4) vs. 11 (IQR, 2–23); Z=2.968, P=0.003] and the PPS dataset [2 (IQR, 0–14) vs. 11 (2, 27); Z=2.687, P=0.007]. Conclusion:Compared with the EEA group, bowel function was superior in the SEA group 1 year after surgery and during long-term follow-up.

OBJECTIVE: This review summarized the first 10-year progresses and controversies in the concept of anteromedial cortical support reduction, to provide references for further study and clinical applications. METHODS: Relevant domestic and foreign literature on cortical support reduction was extensively reviewed to summarize the definition of positive, neutral, and negative support, anteromedial cortices at the inferior corner, intraoperative technical tips for fracture reduction, radiographic assessment at different periods, comparison between positive versus neutral and medial versus anterior support, and the clinical efficacy of Chang reduction quality criteria (CRQC) and postoperative stability score. RESULTS: Anteromedial cortical support reduction was only focused on the cortex of anteromedial inferior corner, with no concern the status of lateral wall or lesser trochanter. Anteromedial cortex was seldom involved by fracture comminution, it was thicker, denser, and stronger, and was the key for mechanical buttress of the head-neck fragment to share compression load. Positive, neutral, and negative support were also called "extramedullary, anatomic, and intramedullary reduction", respectively. There was hardly seen parallel cortical apposition, but characterized by some kinds of head-neck rotation, for example 10°-15° flexed rotation for positive cortical contact and support. Due to intraoperative compression and postoperative impaction, the status of cortical support may be changed at different time of radiographic examination. The positive medial cortex support was more reliable with less reduction loss than its neutral counterpart, and the anterior cortex contact was more predictive than the medial cortex for final results. As incorporation the bearing of cortex apposition and using a 4-point score, CRQC demonstrated more efficacy and was gradually accepted and applied in the evaluation of trochanteric fracture reduction quality. Postoperative stability score (8 points) provided a assessment tool for early weight-bearing in safety to prevent mechanical failure. CONCLUSION Anteromedial cortical support reduction is a key point for stability reconstruction in the treatment of trochanteric femur fractures. Evidence has definitely shown that non-negative (positive and neutral) is superior to negative (loss of cortical support). There is a tendency that positive cortex support is superior to neutral, but high quality study with large sample size is needed for a clear conclusion.
Humans ; Femur/diagnostic imaging* ; Fracture Fixation, Internal/methods* ; Hip Fractures/diagnostic imaging* ; Treatment Outcome ; Fracture Fixation, Intramedullary/methods*

Objective To explore the value of the combination of serum hemoglobin A1c(HbA1c),Alarin and Ficolin-3 in predicting adverse pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods From March 2021 to March 2023,129 GDM patients who underwent prenatal examination and hospital delivery in Yantai Yeda Hospital were collected as the GDM group,while 133 pregnant women with normal glucose tolerance test results were regarded as the control group.Fully automated glycated hemoglobin analyzer was applied to detect serum HbA1c level.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum Alarin and Ficolin-3 levels.Pearson method was used to analyze the correlation between serum HbA1c,Alarin,Ficolin-3 levels and 2 hour postprandial glucose(2 h PG),fasting blood glucose(FBG)and homeostasis model assessment method for insulin resistance(HOMA-IR)in GDM patients.Logistic regression was applied to analyze the relationship between HbA1c,Alarin,Ficolin-3 levels and adverse pregnancy outcomes in GDM patients.Receiver operating characteristic(ROC)curve was plotted to analyze the value of serum HbA1c,Alarin and Ficolin-3 levels in predicting adverse pregnancy outcomes in GDM patients.Results The 2 h PG,FBG,HOMA-IR,and serum HbA1c,Alarin,and Ficolin-3 levels were significantly higher in the GDM group than those in the control group(P＜0.05).The serum levels of HbA1c,Alarin and Ficolin-3 were positively correlated with 2 h PG,FBG and HOMA-IR in GDM patients(P＜0.05).The serum HbA1c,Alarin and Ficolin-3 levels were greatly higher in GDM patients with poor blood glucose control than those in GDM patients with good blood glucose control(P＜0.05).The above levels of three indicators in GDM patients with adverse pregnancy outcomes were significantly higher than those in GDM patients without adverse pregnancy outcomes(P＜0.05).Elevated levels of HbA1c,Alarin and Ficolin-3 were independent risk factors for adverse pregnancy outcomes in GDM patients(P＜0.05).The area under the curves of HbA1c,Alarin and Ficolin-3 alone and in combination were 0.840,0.865,0.815 and 0.979,respectively in predicting adverse pregnancy outcomes in GDM patients.Conclusion The serum HbA1c,Alarin and Ficolin-3 levels are abnormally elevated in GDM patients,and the combined detection of the three can improve the value in predicting adverse pregnancy outcomes.

Background The incidence rate of missed abortion is increasing year by year, but the etiology has not been fully elucidated. Adverse pregnancy history and exposure to polycyclic aromatic hydrocarbons (PAHs) may increase the risk of missed abortion. Objective To investigate the interaction between adverse pregnancy history and PAHs exposure on missed abortion in early pregnancy, and to provide evidence for the etiologic research of missed abortion. Methods A total of 114 pregnant women diagnosed with missed abortion in the Department of Obstetrics of the First Hospital of Shanxi Medical University from March to December 2019 were selected as the case group, and 139 pregnant women who visited the same hospital for voluntary induced abortion in the same period as the control group, to collect basic information and medical information of abortion, stillbirth, intrauterine growth retardation, and other adverse pregnancy history. Abortion villus tissues were collected to detect PAH-DNA adducts levels, stratified by pregnancy and adverse pregnancy history and grouped by quartile method: Q₁ (< 404.61 ng·L⁻¹), Q₂ (404.61−453.75 ng·L⁻¹), Q₃ (453.76−506.72 ng·L⁻¹), and Q₄ (≥506.73 ng·L⁻¹). SPSS 25.0 statistical software was used for χ² test and multiple logistic regression, and additive and multiplicative models were used to investigate the interaction between adverse pregnancy history and PAH-DNA adducts level on missed abortion. The PAH-DNA adducts were grouped by tertiles and quartiles, and P₃₃, P₅₀, P₆₇ and P₇₅ were used as data cut points for sensitivity analysis. Results The proportion of adverse pregnancy history in the case group (32.46%) was higher than that in the control group (12.23%) (P < 0.001). Among 160 subjects with≥2 pregnancies, the proportion of adverse pregnancy history in the case group (57.81%) was higher than that in the control group (17.71%) (P < 0.001). The results of χ² test stratified by pregnancy for different PAH-DNA adducts levels between the two groups showed that the PAH-DNA adducts level was associated with missed abortion in subjects with≥2 pregnancies (χ²=10.14, P=0.017). Being further stratified by adverse pregnancy history, the PAH-DNA adducts level in subjects with no adverse pregnancy history was associated with missed abortion (χ²=9.70, P=0.021). The results of logistic regression analysis showed that adverse pregnancy history (OR=5.88, 95%CI: 2.79−12.39) and PAH-DNA adducts (OR=3.01, 95%CI: 1.22−7.40) increased the risk of missed abortion, but no interaction between them was found. The relative excess risk of interaction (RERI), the attributable percentage of interaction (AP), and the synergy index (SI) and its 95%CI were 0.60 (95%CI: −0.58−1.77), 0.74 (95%CI: −0.83−2.30), and 0.20 (95%CI: 0.01−5.43), respectively. Conclusions Adverse pregnancy history and PAH-DNA adducts in pregnant women may increase the risk of missed abortion. The effect of the interaction between them on the occurrence of missed abortion is not supported by the current study.

Objective:To evaluate the efficacy and safety of primary tumor resection for asymptomatic metastatic colorectal cancer with unresectable metastases.Methods:A literature search was conducted in PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure and WanFang databases to identify studies comparing primary tumor resection and systemic treatment for asymptomatic metastatic colorectal cancer with unresectable metastases until March 31, 2021 (inchuding RCTs and non-RCTs) . The search strategy was: (((colorectal cancer) OR (colorectal neoplasms) OR (colon cancer) OR (colon neoplasms) OR (rectal cancer) OR (rectal neoplasms)) AND ((metastatic) OR (stage Ⅳ)) AND (asymptomatic) AND (primary tumor resection)). Review manager (RevMan) (Version 5.3.0, Cochrane Collaboration, Oxford, UK) was used to perform the statistical analysis.Results:A total of 14 original studies (RCT: 1; cohort study: 13) were included in this analysis with a total of 2123 patients (primary tumor resection: 1162 cases, systemic treatment: 961 cases). The results of this Meta-analysis showed that PTR group had a significantly improved overall survival in 1-year overall survival ( HR=0.80, 95% CI: 0.67~0.95, P=0.01), 2-year overall survival ( HR=0.81, 95% CI: 0.71~0.93, P=0.002), 3-year overall survival ( HR=0.82, 95% CI: 0.72~0.92, P=0.001), 4-year overall survival ( HR=0.86, 95% CI: 0.75~0.98, P=0.02) and 5-year overall survival ( HR=0.85, 95% CI: 0.74~0.97, P=0.02). The median survival time of PTR group was 4.35 months longer than that of systemic treatment group ( MD=4.35, 95% CI: 0.99~7.72, P=0.015). Conclusions:The current evidence suggests that primary tumor resection may be a potentially safe and feasible treatment strategy for asymptomatic metastatic colorectal cancer with unresectable metastases. Large sample size prospective randomized controlled trials are needed to validate our findings in the future.

Objective:To investigate the efficacy and prognosis of three surgical methods for presacral recurrent rectal cancer (PRRC).Methods:A retrospective cohort study was carried out. Case inclusion criteria: (1) primary rectal cancer without distant metastasis and undergoing radical surgery; (2) patients undergoing radical surgery after the diagnosis of PRRC; (3) complete inpatient, outpatient and follow-up data. Clinical data of 47 patients meeting the above criteria who underwent operation at the Department of Gastrointestinal Surgery, The Peking University People's Hospital from January 2008 to December 2017 were reviewed and analyzed retrospectively. Of the 47 patients, 31 were male and 16 were female; the mean age was 57 years old; 9 (19.1%) were low differentiation or signet ring cell carcinoma, 38 (80.9%) were medium differentiation; 19 (40.4%) received neoadjuvant therapy. According to operative procedure, 22 patients were in the abdominal/abdominoperineal resection group, 15 in the sacrectomy group and 10 in the abdominosacral resection group. The operative data, postoperative data and prognosis were compared among the three groups. Survival curve was conducted using the Kaplan-Meier method, and log-rank test was used to compare survival difference among three groups.Results:There were no significant differences in baseline data among three groups (all P>0.05). All the 47 patients completed the radical resection successfully. The mean operation time was (4.7±2.1) hours, the median intraoperative blood loss was 600 ml, and the median postoperative hospitalization time was 17 days. Fifteen cases (31.9%) had perioperative complications, of which 3 cases were grade III-IV. There was no perioperative death. The mean operative time was (7.4±1.6) hours in the abdominosacral resection group, (4.9±1.6) hours in the abdominal/abdominoperineal resection group, and (3.0±1.1) hours in the sacroectomy group, with a significant difference ( F=25.071, P<0.001). There were no significant differences in intraoperative blood loss, postoperative hospitalization days and perioperative complications among the three groups (all P>0.05). The median follow-up period of all the patients was 24 months, 12 cases (25.5%) developed postoperative dysfunction. The incidence of postoperative dysfunction in the abdominosacral resection group was 5/10, which was higher than 4/15 in the sacrectomy group and 3/22 (13.6%) in the abdominoperineal resection group with statistically significant difference (χ 2=9.307, P=0.010). The 1-year and 3-year overall survival rates were 86.1% and 40.2% respectively. The 1-year overall survival rates were 86.0%, 86.7% and 83.3%, and the 3-year overall survival rates were 33.2%, 40.0% and 62.5% in the abdominal/abdominoperineal resection group, sacrectomy group and abdominosacral resection group, respectively, whose difference was not statistically significant (χ 2=0.222, P=0.895). Conclusions:Abdominal/abdominoperineal resection, sacrectomy and abdominosacral resection are all effective for PRRC. Intraoperative function protection should be concerned for patients undergoing abdominosacral resection.

Objective:To investigate the clinicopathological features and prognostic factors in patients with presacral recurrent rectal cancer (PRRC).Methods:PRRC was defined as recurrence of rectal cancer after radical surgery involving posteriorly the presacral soft tissue, the sacrum/coccyx, and/or sacral nerve root. The diagnosis is confirmed with clinical symptoms (pain of pelvis/back/lower limb, bloody stools, increased frequency of defecation, and abnormal secretions), physical examination of perineal or pelvic masses, radiological findings, colonoscopy with histopathological biopsy, and the evaluation by multi-disciplinary team (MDT). Inclusion criteria: (1) primary rectal cancer undergoing radical surgery without distant metastasis; (2) PRRC was diagnosed; (3) complete inpatient, outpatient and follow-up data. According to the above criteria, clinical data of 72 patients with PRRC in Peking University People′s Hospital from January 2008 to December 2017 were retrospectively analyzed. The clinicopathological features and follow-up data were summarized. Cox proportional hazard models was used to analyze the prognostic factors of PRRC.Results:Among 72 patients, 45 were male and 27 were female with a male-to-female ratio of 1.7:1.0. The median age at recurrence was 58 (34 to 83) years and the median interval from surgery to recurrence was 2.0 (0.2 to 17.0) years. The main symptom was pain in 48.6% (35/72) of patients. In addition, gastrointestinal symptoms were found in 25.0% (18/72) of patients. The presacral recurrent sites were presacral fascia in 36 (50.0%) patients, lower sacrum (S3~S5 or coccyx) in 25 (34.7%) patients, and higher sacrum (S1~S2) in 11 (15.3%) patients. Forty-seven (65.3%) patients underwent radical surgery (abdominal resection, abdominoperineal resection, sacrectomy, abdominosacral resection), 12 (16.7%) underwent non-radical surgery (colostomy, cytoreductive surgery), and 13 (18.1%) did not undergo any surgery but only receive palliative chemoradiotherapy and nutritional support treatment. Thirty-three (45.8%) patients received radiotherapy and/or chemotherapy (oxaliplatin, 5-fluorouracil, capecitabine, irinotecan, etc.). All the patients received follow-up, and the median follow-up time was 19 (2 to 72) months. The median overall survival time was 14 (1 to 65) months. The 1- and 3-year overall survival rates were 67.1% and 32.0%, respectively. Univariate analysis showed that age at recurrence ( P=0.031) and radical resection ( P<0.001) were associated with prognosis. Multivariate analysis demonstrated that radical resection was independent factor of good prognosis (RR=0.140, 95%CI: 0.061-0.322, P<0.001). Conclusions:Patients tend to develop presacral recurrent rectal cancer within 2 years after primary surgery. The main symptom is pain. Patients undergoing radical resection have a relatively good prognosis.

Objective:To investigate the efficacy and prognosis of three surgical methods for presacral recurrent rectal cancer (PRRC).Methods:A retrospective cohort study was carried out. Case inclusion criteria: (1) primary rectal cancer without distant metastasis and undergoing radical surgery; (2) patients undergoing radical surgery after the diagnosis of PRRC; (3) complete inpatient, outpatient and follow-up data. Clinical data of 47 patients meeting the above criteria who underwent operation at the Department of Gastrointestinal Surgery, The Peking University People's Hospital from January 2008 to December 2017 were reviewed and analyzed retrospectively. Of the 47 patients, 31 were male and 16 were female; the mean age was 57 years old; 9 (19.1%) were low differentiation or signet ring cell carcinoma, 38 (80.9%) were medium differentiation; 19 (40.4%) received neoadjuvant therapy. According to operative procedure, 22 patients were in the abdominal/abdominoperineal resection group, 15 in the sacrectomy group and 10 in the abdominosacral resection group. The operative data, postoperative data and prognosis were compared among the three groups. Survival curve was conducted using the Kaplan-Meier method, and log-rank test was used to compare survival difference among three groups.Results:There were no significant differences in baseline data among three groups (all P>0.05). All the 47 patients completed the radical resection successfully. The mean operation time was (4.7±2.1) hours, the median intraoperative blood loss was 600 ml, and the median postoperative hospitalization time was 17 days. Fifteen cases (31.9%) had perioperative complications, of which 3 cases were grade III-IV. There was no perioperative death. The mean operative time was (7.4±1.6) hours in the abdominosacral resection group, (4.9±1.6) hours in the abdominal/abdominoperineal resection group, and (3.0±1.1) hours in the sacroectomy group, with a significant difference ( F=25.071, P<0.001). There were no significant differences in intraoperative blood loss, postoperative hospitalization days and perioperative complications among the three groups (all P>0.05). The median follow-up period of all the patients was 24 months, 12 cases (25.5%) developed postoperative dysfunction. The incidence of postoperative dysfunction in the abdominosacral resection group was 5/10, which was higher than 4/15 in the sacrectomy group and 3/22 (13.6%) in the abdominoperineal resection group with statistically significant difference (χ 2=9.307, P=0.010). The 1-year and 3-year overall survival rates were 86.1% and 40.2% respectively. The 1-year overall survival rates were 86.0%, 86.7% and 83.3%, and the 3-year overall survival rates were 33.2%, 40.0% and 62.5% in the abdominal/abdominoperineal resection group, sacrectomy group and abdominosacral resection group, respectively, whose difference was not statistically significant (χ 2=0.222, P=0.895). Conclusions:Abdominal/abdominoperineal resection, sacrectomy and abdominosacral resection are all effective for PRRC. Intraoperative function protection should be concerned for patients undergoing abdominosacral resection.

Objective:To investigate the clinicopathological features and prognostic factors in patients with presacral recurrent rectal cancer (PRRC).Methods:PRRC was defined as recurrence of rectal cancer after radical surgery involving posteriorly the presacral soft tissue, the sacrum/coccyx, and/or sacral nerve root. The diagnosis is confirmed with clinical symptoms (pain of pelvis/back/lower limb, bloody stools, increased frequency of defecation, and abnormal secretions), physical examination of perineal or pelvic masses, radiological findings, colonoscopy with histopathological biopsy, and the evaluation by multi-disciplinary team (MDT). Inclusion criteria: (1) primary rectal cancer undergoing radical surgery without distant metastasis; (2) PRRC was diagnosed; (3) complete inpatient, outpatient and follow-up data. According to the above criteria, clinical data of 72 patients with PRRC in Peking University People′s Hospital from January 2008 to December 2017 were retrospectively analyzed. The clinicopathological features and follow-up data were summarized. Cox proportional hazard models was used to analyze the prognostic factors of PRRC.Results:Among 72 patients, 45 were male and 27 were female with a male-to-female ratio of 1.7:1.0. The median age at recurrence was 58 (34 to 83) years and the median interval from surgery to recurrence was 2.0 (0.2 to 17.0) years. The main symptom was pain in 48.6% (35/72) of patients. In addition, gastrointestinal symptoms were found in 25.0% (18/72) of patients. The presacral recurrent sites were presacral fascia in 36 (50.0%) patients, lower sacrum (S3~S5 or coccyx) in 25 (34.7%) patients, and higher sacrum (S1~S2) in 11 (15.3%) patients. Forty-seven (65.3%) patients underwent radical surgery (abdominal resection, abdominoperineal resection, sacrectomy, abdominosacral resection), 12 (16.7%) underwent non-radical surgery (colostomy, cytoreductive surgery), and 13 (18.1%) did not undergo any surgery but only receive palliative chemoradiotherapy and nutritional support treatment. Thirty-three (45.8%) patients received radiotherapy and/or chemotherapy (oxaliplatin, 5-fluorouracil, capecitabine, irinotecan, etc.). All the patients received follow-up, and the median follow-up time was 19 (2 to 72) months. The median overall survival time was 14 (1 to 65) months. The 1- and 3-year overall survival rates were 67.1% and 32.0%, respectively. Univariate analysis showed that age at recurrence ( P=0.031) and radical resection ( P<0.001) were associated with prognosis. Multivariate analysis demonstrated that radical resection was independent factor of good prognosis (RR=0.140, 95%CI: 0.061-0.322, P<0.001). Conclusions:Patients tend to develop presacral recurrent rectal cancer within 2 years after primary surgery. The main symptom is pain. Patients undergoing radical resection have a relatively good prognosis.