Investigation of the clinical efficacy of transabdominal single-port endoscopic combined with transanal endoscopic techniques in managing low rectal cancer
Objective To explore the short-term and mid-term clinical effects of single-port laparoscopy combined with transanal total mesenteric excision for treating low rectal cancer.Methods From January 2018 to June 2022,patients diagnosed with low rectal cancer and treated with anterior rectal resection and coloanal anastomosis at Lishui Central Hos-pital were included in this study.The early and mid-term clinical efficacies were analyzed and compared based on speci-men extraction methods.Results Among the 62 patients,the average operation time was(182.6±30.5)minutes,with 22 requiring internal sphincter resection.All patients underwent either colostomy end-to-end stapler or manual anastomo-sis.The first bowel movement at the ileostomy site occurred on average(1.5±0.3)days post-surgery.R0 resection was achieved in 61 patients,with only 1 patient of R1 resection.The average distal resection margin was(6.2±0.3)mm,and 3 patients had positive circumferential resection margins.Pathological analysis showed that 45 complete and 17 nearly complete cases.The average number of lymph nodes obtained was 13.5,with 25 patients yielding fewer than 12 lymph nodes on their specimens.Specimens were extracted from the ileostomy site in 35 cases and through the anal canal in 27 cases.There were significant differences in BMI-related variables(x2=39.388,P＜0.001)and tumor size(t=4.415,P=0.020)between the two methods.The average postoperative follow-up time was(40.6±5.5)months.The mid-term outcome evaluation indicated an overall survival rate of 98.4％,disease-free survival rate of 80.6％,and local control rate of 95.2％among the study subjects.Conclusion Laparoscopy combined with transanal endoscopic techniques can achieve ideal short-and medium-term clinical effects in the treatment of low rectal cancer,facilitate sufficient tumor resec-tion,and minimize complications through smaller wounds.
Low rectal cancerMinimally invasiveLaparoscopyTransanal total mesentery resection
维普
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