Comparison Of Clinical Effects Between Laparoscopic Assisted And Open Sphincter Preservation Operation For Low Rectal Cancer

Objective: Comparing and exploring the differences of clinical effects between laparoscopic assisted and open sphincter preservation operation To investigate the safety,micro-invasion and superiority of laparoscopic assisted sphincter preservation operation for low rectal cancer.Methods: From January 2009 to September 2014,clinical data of 33 patients with low-rectal cancer received laparoscopic assisted sphincter preservation operation and data of 39 cases who received open sphincter preservation operation were reviewed retrospectively in the First Affiliated Hospital of Dalian Medical University,and all the patients were divided into two groups named as the laparoscopic-assisted group and the open group. Some indexes were used to explore the differences between the two groups,such as the operation time,blood loss,recovery indexes(the time to flatus,the time to defecated,the time of hospital stay,the usage of pain-killer),the incidences of complications,postoperative pathology( length of upper edge,length of distal edge,number of lymph),the defecation functions,local recurrence rate,distant metastatic rate,mean survival time.Results: All operations the 72 patients received got to the radical treatment standard. The anus of all patients were preserved,and no preventive colostomy. The operation time in laparoscopic-assisted group and open group was 229 min and 161min;the blood losses were 36 ml and 57ml;there were statistical difference between the two groups.The time to flatus was 3d and 4d;the time to defecated was 9d and 7d;the time of hospital stay was 13 d and 18d; The frequency of the usage of pain-killer was 1.5 and 2.7;The Wexner constipation score was 13 and 14,;there were statistical difference between the two groups. The length of distal edge was 3.5cm and 2.9cm;The incidences of complications was 15.1%(5/33) and 35.9%(14/39);there were statistical difference between the two groups. The number of lymph was 16 and 13;local recurrence rate was 6% and 7.7%;distant metastatic rate was 9.1% and 12.8%;mean survival time was 45.7 months and 54.5 months;there were no statistical difference between the two groups.Conclusion: There are some merits the laparoscopic resection have:the less blood loss, the shorter time to recovery, the mild pain, and the lower complication rate comparing open sphincter preservation operation for low rectal cancer. the laparoscopic resection protect the anal function better than open sphincter preservation operation; The laparoscopic resection can achieve the same radical resection standard or even better results as open surgery. laparoscopic assisted sphincter preservation operation is safe, minimally invasive and feasible for low rectal cancer. It is a good choice for earlier stage of patients with low rectal cancer to select laparoscopic resection.