Comparison Of Clinical Effects Between Laparoscopic And Open Total Mesorectal Excision With Sphincter Preservation For Low Rectal Cancer

Objective: The efficacy and safety of Total Mesorectal Excision with sphincter preservation versus open TME sphincter preservation in patients with low rectal cancer were analyzed.Methods: Retrospective analysis of 75 cases of low rectal cancer TME sphincter preservation surgery in Longgang Central Hospital from January 2014 to June 2017 were retrospectively analyzed,36 cases of laparoscopic TME with sphincter preservation,39 cases of open TME with sphincter preservation,comparison of two groups with general information,operative outcome,postoperative situation and follow-up.Results: Laparoscopic group and open group operation time and number of lymph node dissection were 137.08±18.76 minutes and 130.51±24.03 minutes,P=0.194;13.80±2.00 and 11.77±2.66,P=0.198,the difference was not statistically Meaning;laparoscopic group bleeding 63.48±21.14 ml,less than the open group 110±21.34ml(P=0.000);Distal Resection Margin(DRM)of laparoscopic group was 3.19±0.67 cm,which was longer than that of open group 2.69±0.32 cm.There was statistical significance between the two groups(P=0.000).The recovery time of intestinal function,drainage time of drainage tube,length of hospital stay,required rate of postoperative analgesia and postoperative complications in laparoscopic group were less than those in open group:2.89±0.71 days and 3.69±0.77 days,P=0.000;7.59±1.02 days and 9.18±0.88 days,P=0.000;13.69±1.56 days and 16.05±1.12 days,P=0.000;16.7% and 38.5%,P=0.036;16.7% and 41.0%,P=0.021.In the laparoscopic group,the rate of good anus was 91.7% and that of the open group was 76.9%,both of which were statistical difference(P=0.049).The rates of local recurrence and distant metastasis in laparoscopic group and open group were 2.8% and 7.7% %,P=0.666;13.9% and 10.3%,P=0.898,there were no statistical difference between the two groups.Conclusion: The procedure of laparoscopic TME with sphincter preservation is safe and feasible for low rectal cancer,compared with open operation,patients with less postoperative pain and quick recovery,both to ensure the radical tumor,which can achieve not only radical demands but good anal function.