Comparative Analysis Of Clinical Efficacy Of Laparoscopic And Open Low Anterior Resection Of Rectal Cancer

Objective:By comparing the short-term and long-term clinical efficacy of laparoscopic and open low anterior resection of rectal cancer,clinical evidence was provided for the application and promotion of laparoscopic technology,and reference was provided for the selection of surgical methods in the diagnosis and treatment of rectal cancer..Methods:The clinical data of 75 patients who underwent laparoscopic low anterior resection of rectal cancer in the gastrointestinal surgery of the First Affiliated Hospital of Hebei North University from January 2015 to December 2017 were collected as the laparoscopic group(LRR group),and the clinical data of 75 patients who underwent open low anterior resection of rectal cancer in the same period were selected as the open group(ORR group).The clinical data of the two groups were retrospectively analyzed.The intraoperative blood loss,operation time,postoperative recovery index,postoperative complications and prognosis of the two groups were compared.Results:1.There was no significant difference in age,gender,NRS-2002 and postoperative pathological TNM stage between the two groups(P>0.05),and the data of the two groups were comparable.2.LRR group and ORR group in the intraoperative observation index comparison results : the average intraoperative blood loss were(64.20± 27.03 ml VS 79.88± 22.64 ml,P<0.05),the average operation time were(160.04 ± 32.13 min VS 126.00 ± 19.15 min,P<0.05),compared with ORR group,LRR group intraoperative blood loss decreased,but the operation time is relatively long.3.The average first exhaust time of LRR group and ORR group were(2.48 ± 0.55 d VS 3.98 ± 1.01 d,P<0.05).The average first feeding time was(2.84± 0.70 d VS 4.89± 2.26 d,P<0.05).The average indwelling time of abdominal drainage tube was(5.99± 1.06 d VS8.20 ± 2.70 d,P<0.05).The indwelling time of catheter was(1.78 ± 0.84 d VS 2.20 ± 0.91 d,P<0.05).The average postoperative hospital stay was(10.00 ± 3.13 d VS 12.37 ± 4.20 d,P<0.05),and the difference was statistically significant.4.There were 12 cases(16%)of postoperative complications in LRR group,including 4 cases of intestinal obstruction,5cases of pulmonary infection,2 cases of incision infection and anastomotic leakage,3 cases of urinary dysfunction,2 cases of deep venous thrombosis of lower extremities,and other complications(2 cases of anastomotic stenosis,1 case of anastomotic bleeding,3 cases of urinary infection).There were 25 cases(33%)of postoperative complications in the ORR group,9 cases of pulmonary infection,8 cases of incision infection,6 cases of intestinal obstruction,6 cases of urinary dysfunction,3 cases of anastomotic leakage and 3 cases of deep venous thrombosis of lower limbs,and other complications(anastomotic stenosis in 2 cases,anastomotic bleeding in 1 case,and urinary infection in 3cases).There was a statistically significant difference in the total number of complications between the LRR group and the ORR group(P <0.05).5.In terms of the comparison results of prognostic indicators,there were 15 cases of local recurrence and metastasis in the LRR group within 42 months of follow-up,and the recurrence and metastasis rate was 21.70%.In the ORR group of 17 cases,the recurrence and metastasis rate was22.67%,and the recurrence and metastasis rates in the LRR group and the ORR group were not statistically significant(P>0.05).The 3-year disease-free survival rate and overall survival rate of LRR group were82.7% and 88.1%,respectively.ORR group was 77.3% and 89.1%.There was no significant difference between the two groups(P>0.05).Conclusion : 1.Compared with open surgery,laparoscopic low anterior resection of rectal cancer has the advantages of less intraoperative blood loss,faster postoperative intestinal function recovery,shorter postoperative drainage tube removal time and shorter postoperative hospitalization time.2.The total incidence of postoperative complications of laparoscopic low anterior resection of rectal cancer is less than open surgery.3.There was no significant difference in the recurrence and metastasis rate,DFS rate,and OS rate between laparoscopic anterior resection of rectal cancer and open surgery,and the two groups had the same long-term efficacy.