Effects of 3D laparoscopic trans-sacrococcygeal and transabdominal perineal in the treatment of low rectal cancer / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of 3D laparoscopic trans-sacrococcygeal and transabdominal perineal in the treatment of low rectal cancer.Methods:The clinical data of 86 patients with low rectal cancer admitted to Qilu Hospital of Shandong University(Qingdao) from January 2017 to January 2020 were collected retrospectively, and they were divided into the control group and the observation group by the different surgical approaches, with 43 cases in each group. The control group was treated with 3D laparoscopic transabdominal perineal resection of rectal cancer, and the observation group was treated with 3D laparoscopic trans-sacrococcygeal resection of rectal cancer. Perioperative indexes in the two groups were recorded. The levels of carbohydrate antigen (CA)242, CA724, and carcinoembryonic antigen (CEA) were compared before and 6 months after the surgery. Follow-up was arranged to record the local recurrence rate and survival rate.Results:The operative time, intraoperative blood loss, exhaust time, hospitalization time in the observation group were lower than those in the control group (182.04 ± 50.87) min vs. (210.59 ± 61.03) min, (89.18 ± 12.57) ml vs. (116.58 ± 22.09) ml, (2.94 ± 0.58) d vs. (4.56 ± 1.07) d, (10.65 ± 2.03) d vs. (14.06 ± 2.84) d, the differences were statistically significant ( P<0.05). The urination function of the observation group recovered well after the surgery, and there was statistical significance in the grading of urination function between the two groups ( P<0.05). The levels of CEA, CA242 and CA274 in the observation group at 6 months after the surgery were lower than those in the control group (4.13 ± 0.46) μg/L vs. (5.01 ± 0.72) μg/L, (14.01 ± 5.16) kU/L vs. (16.97 ± 5.76) kU/L, (4.19 ± 0.68) kU/L vs. (4.97 ± 0.87) kU/L, the differences were statistically significant ( P<0.05). The survival rate in the observation group was higher than that in the control group 88.37%(38/43) vs. 69.77%(30/43); and the recurrence rate was lower than that in the control group 4.65%(2/43) vs. 27.91%(12/43), the differences were statistically significant ( χ2 = 4.50, 8.53, P<0.05). Conclusions:3D laparoscopic trans-sacrococcygeal resection of rectal cancer can effectively shorten the operation time, reduce the amount of bleeding, but also improve the patient's anal function, and has low local recurrence rate, which is worthy of clinical promotion.