| Objective: Laparoscopic radical resection of rectal cancer has developed more mature and is currently the only effective method to cure colorectal cancer.Exposure of the low mesorectal space during the operation has always been the focus and difficulty of rectal surgery.Especially for some patients with pelvic stenosis and relatively large or low tumor,adopting any traditional surgical approach will increase the exposure of the operative field of vision.Difficulty,so the quality of surgery will also have certain defects.In this study,meta-analysis was used to compare the difference between transanal minimally invasive surgery(TAMS-TME)and conventional surgery to explore the feasibility of TAMIS in the treatment of rectal cancer.Methods: By searching multiple Chinese and English databases such as “Pub Med”,“Embase”,“Million Party”,“China Knowledge Network”,etc.,the time request field is positioned as the TAMIS surgical treatment for rectum published from January 2011 to Deceber 2016.The relevant literature on cancer,extraction time,intraoperative blood loss,length of hospital stay,peripheral resection margin length,number of lymph node dissections around the rectum,and complications,were used for meta-analysis of screening requirements.Results: This study included 5 articles in Chinese and 7 in English,a total of 12 articles that met the study.Ten documents from the selected literature describe the operation time of the two groups in detail.The results are expressed in the form of mean and standard deviation.The results show that: in the operation time of rectal cancer treatment,TAMIS-TME surgery in treatment of colorectal cancer surgery time is shorter than the traditional operation(SMD =-0.51,95% CI-0.93 ~-0.10,P <0.00001),which was statistically significant results;selected documents for a total of 9 Document blood loss has been particularly described and recorded results using mean and standard deviation displayed in the form: TAMIS-TME surgical blood loss was significantly less than traditional surgery group(SMD =-1.00,95% CI-1.75 ~-0.25,P<0.00001),the difference was statistically significant;in the selected literature,a total of 6 articles had detailed records of the patient's length of stay.The results were described in terms of mean and standard deviation.The hospitalization time showed that the TAMIS-TME operation group was shorter than the traditional operation(SMD =-0.93,95%CI-1.55~-0.30,P<0.00001),and the difference was statistically significant;7 literature pairs The distance from the circumferential margin of the tumor was recorded and the results were expressed in the form of mean and standard deviation.The results showed that the TAMIS procedure can obtain a good surgical margin compared with the traditional surgical technique(SMD = 0.37,95% CI-0.05-0.78).(P=0.00001).The difference was statistically significant.A total of 10 articles in the selected literature described the number of intraoperative lymph node dissections.The results were expressed in terms of mean and standard deviation: TAMIS group was superior to traditional In the surgical group(SMD = 0.59,95% CI-0.19 to 1.17,P < 0.00001),the difference was statistically significant;a total of 6 articles in the selected literature reported postoperative complications.The results showed that: The incidence of postoperative complications(OR=1.00,95% CI 0.01 to 1.63,P=0.936)was not statistically different from that of traditional surgical treatment of rectal cancer.Conclusion: TAMIS surgery in the treatment of the colorectal cancer compared with traditional surgery group can greatly shorten the operation time,reduce intraoperative blood loss,reduce the patients' hospitalization days,intraoperative cleaning more lymph nodes,still can obtain satisfactory surgical circumferential cutting edge;But in the incidence of surgical complications is less than that of traditional surgery,TAMIS-TME can be used as a surgical method for rectal cancer treatment. |
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