Interventions
tumor, pain
TUMOR
Following randomization, laparoscopic TME surgery was performed. In the Con-group, dissection of the anterior rectum was performed anterior to DVF, and the fascia was resected by an “inverted U-shaped” incision ≥2 cm beneath the tumor. In contrast, for the Exp-group, dissection was performed posterior to DVF and thus DVF was preserved entirelyTo ensure the surgical homogeneity and quality, video recordings of each procedure were stored for reference, and mandatory intraoperative photographs of specific fields to verify PAN protection were obtained illustrating: (1) the area of ligation of the inferior mesenteric artery, (2) the area of bilateral hypogastric nerve, (3) bilateral rectal ligament area, (4) the anterior rectal wall and DVF area. The integrity of the gross specimen and histopathological examination for TME grading classification were evaluatedPostoperative prophylactic antibiotics and pain medications, fluid therapy, and nutritional support were administered in accordance with routine medical practice. Adjuvant chemotherapy was arranged if needed, using capecitabine, CapeOX, or mFOLFOX6 regimen.