Effect of anal draw-out laparoscopic anterior resection of rectal cancer on gastrointestinal motility and prognosis in patients with low rectal cancer / 国际外科学杂志

ABSTRACT

Objective:To investigate the effect of rectal draw-out laparoscopic anterior resection on gastrointestinal motility and prognosis in patients with low rectal cancer.Methods:A total of 140 patients with low rectal cancer who received treatment in Chongqing Ninth People′s Hospital from May 2017 to May 2018 were selected, including 82 males and 58 females, aged from 35 to 78 years with an average age of (59.33±9.12) years.According to the operation methods, all patients were divided into observation group (transanal pullout laparoscopic anterior resection of rectal cancer, n=70) and the control group (laparoscopic assisted anterior rectal resection, n=70). Independent sample t test or χ2 test were used to compare operation-related indicators, occurrence of complications, changes of fluid gastric emptying, small intestinal transport capacity, gastrin and motilin in 2 groups. Kaplan-meier survival curve was plotted to compare tumor progression-free survival (PFS) and overall survival (OS) in two groups. The two groups of PFS and OS were compared by log-rank test. Results:The operative time, intraoperative blood loss, postoperative drainage volume, and postoperative recovery time of the observation group were lower than those of the control group, the ability of liquid gastric emptying 24 h after operation, small intestine transport function at 24 h and 48 h after operation, the capacity of liquid gastric emptation, intestinal transport function 24 h and 48 h postoperatively, gastrin and motilin levels at 24 h, 48 h and 72 h postoperatively were significantly higher than those of the control group, with statistically significant differences ( P<0.05). Two years PFS (85.71% vs. 81.43%) and OS (92.86% vs. 90.00%) after surgery between the observation group and the control group were not statistically significant ( P>0.05). Conclusion:The anterior resection of rectal cancer by draw-out laparoscope is safe and radical, without increasing postoperative complications. Moreover, the recovery of gastrointestinal function is earlier than traditional laparoscopic assisted rectal cancer resection, which is conducive to improving the postoperative quality of life of patients, and is worthy of clinical promotion.