Abstract: Background and purpose: Neoadjuvant chemoradiotherapy has become standard treatment modality for locally advanced mid-low rectal cancer. This study aimed to analyze the risk factors of stenosis and distortion in reconstructed rectum after neoadjuvant chemoradiotherapy and anterior resection, and to discuss its clinical management methods. Methods: In this study, we retrospectively and continuously collected the data of patients in the colorectal database of colorectal surgery and clinical register database of radiation. Stenosis grading system was constructed by means of electronic fibrous colonoscope. SPSS 19.0 software package was used in the study, standard chi-square test was used for risk factor analysis, and P<0.05 was set as statistical significance. Results: A total of 269 patients received neoadjuvant chemoradiotherapy and anterior resection. The incidence of severe stenosis was 32.7%. Anastomotic leakage and prophylactic stoma were important risk factors. Forty cases of prophylactic or salvage stoma could not be restored within 1 year, among which 72.5% was because of stenosis. Conclusion: Stenosis and distortion of reconstructed rectum after neoadjuvant chemoradiotherapy and anterior resection treatment modality is a new clinical issue which is closely related with leakage and prophylactic stoma.

Key words: Rectal cancer, Neoadjuvant chemoradiotherapy, Surgery, Stenosis, Stoma