en Oncology Oncology Original Article Original Article <span style="display: none;">&nbsp;</span><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:14pt"><b><i><span style="color:blue">Background</span></i></b><i><span style="color:blue">:</span></i> Fecal incontinence is the main morbidity of inter-sphincteric resection (ISR) in ultra-low rectal cancer<span dir="RTL" lang="FA">.</span> Malone Ante grade Continence Enema (MACE) has been proposed for these patients. We aimed to compare the quality of life outcomes in cases with ultra-low rectal cancer who had undergone ISR&plusmn;MACE.<span style="font-size:9.0pt"></span></span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Methods:</span></i></b> The current randomized clinical study was accomplished for two years from December 2016 to February 2018 in Imam Khomeini Hospital (Sari City, I.R.Iran) on 30 patients (15 in each group) with rectal cancer. The inclusion criteria of the study were stage 1 and 2a of low rectal cancer with type 2 and 3 of Rullier&#39;s classification, those who received neoadjuvant chemo radiotherapy. The exclusion criteria were comorbidity diseases, immune deficiency, poor follow-up. The follow-up period was one year. The Quality of Life (Qol) was reported as <span style="background:white">primary endpoint</span>. The EORTC QLQ-C30 score and Wexner questionnaires were used. SPSS Version 22 was used. A <i>p</i>-value less than 0.05 was considered statistically significant.<i><span style="font-size:10.0pt"></span></i></span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Results:</span></i></b> The mean age of patients was 56.23&plusmn;</span></span></span><span style="font-size:12pt"><span style="line-height:14pt"><span new="" roman="" style="font-family:" times=""><m:omath></m:omath></span></span></span><span style="font-size:14px;"><span style="line-height:14pt"><span new="" roman="" style="font-family:" times=""><m:omath><span cambria="" math="" style="font-family:"><m:r><m:rpr><m:scr m:val="roman"><m:sty m:val="p"></m:sty></m:scr></m:rpr>8.72 </m:r></span></m:omath></span></span><span style="line-height:14pt"><span new="" roman="" style="font-family:" times=""><span new="" roman="" style="font-family:" times=""><span style="position:relative"><span style="top:2.5pt"> </span></span></span>years. The overall Qol score was better in the ISR-MACE (P=0.023). The overall Qol was lower in women than in men in both groups. Low anterior resection syndrome score was lower in the ISR plus MACE group than the ISR group (P=0.030). The Wexner score revealed better scores in the ISR with MACE group than the ISR without MACE group (p<0.0001).<b><i><span style="color:blue"></span></i></b></span></span><br> <span style="line-height:14pt"><span new="" roman="" style="font-family:" times=""><b><i><span style="color:blue">Conclusion</span></i></b><i><span style="color:blue">:</span></i> Patients who underwent ISR plus MACE surgery had better defecation control and better quality of life than patients without MACE.<b><i><span style="color:#0033cc"></span></i></b></span></span></span><br> <span style="display: none;">&nbsp;</span> Inter-sphincteric Resection, Rectal Cancer, Quality of Life 546 554 http://caspjim.com/browse.php?a_code=A-10-1800-1&slc_lang=en&sid=1 Mina Alvandipour Minaalvh@yahoo.com 100319475328460037559 100319475328460037559 No Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Science, Sari, Iran Mohammad Yasin Karami yasinkarami@gmail.com 100319475328460037560 100319475328460037560 Yes Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Mahmood Azadfar mahmoudazadfar@gmail.com 100319475328460037561 100319475328460037561 No Department of Suregry, Mazandaran University of Medical Science, Sari, Iran Jamshid YazdaniCharati jamshid_1380@yahoo.com 100319475328460037562 100319475328460037562 No Department of Biostatistics, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran