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| Observation on the Curative Effect of Partial Intersphincteric Resection for Low Rectal Cancer Under Laparoscopic Full Transabdominal Approach |
| CHEN Qingkuang, ZHAO Zimin, ZHEN Honghong, et al |
| The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China |
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Abstract Objective: To observe the clinical efficacy and quality of life of laparoscopic partial internal sphincter resection for low rectal cancer. Methods: From January 2015 to December 2019, 181 patients were selected and divided into observation group, control group 1 and control group 2 according to different surgical methods. The intraoperative and postoperative recovery, radical tumor resection, anal function and quality of life score were collected. Results: The distance between tumor and anal margin in the observation group was lower than that in control group 1 ( 3.72±0.74cm vs 5.67±0.54cm, P<0.05 ), which was statistically significant. Among the three groups of surgical indicators, the amount of bleeding in the observation group and control group 1 was less than that in control group 2 ( 52.3±28.2ml vs 48.2±20.9 ml vs 96.2±27.3 ml ), the operation time was shorter (197±6.8min vs 195±5.4 min vs 208±10.7 min ), and the postoperative hospitalization time was shorter (13.5±4.9 d vs 13.1±3.7d vs 17.3±4.7d ), with statistical significance ( P<0.05 ). There was no significant difference in postoperative complications among the three groups. There was no significant difference in distal margin distance, circumferential margin and lymph node dissection among the three groups in tumor radical resection. The overall survival rates in the three groups were 93.3 %, 90.2 % and 91.7 %, respectively ( P>0.05 ), with no statistical significance. The comparison of anal function between the two groups showed that the resting pressure of anal canal, maximum systolic pressure of anal canal, maximum tolerated volume and defecation frequency in control group 1 were faster than those in the observation group within 3 months after operation, and the good rate of defecation function was higher ( 85.2 %vs 58.3%, P<0.05 ). However, there was no statistical difference in anal function between 3 and 6 months after surgery ( P>0.05 ).In the quality of life score of tumor patients, the anus-preserving patients in the observation group were significantly higher than those in control group 2 ( P<0.05 ). The gradual recovery of anal function helps to improve the quality of life. Conclusion: Laparoscopic total transabdominal partial internal sphincter resection and anal sphincter preservation for patients with low rectal cancer has good postoperative clinical efficacy and anal function recovery, which is helpful to improve the quality of life of patients and has certain safety and feasibility.
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2021, Vol. 27 
