Clinical application of stapler placement via distal rectal incision in laparoscopic radical resection for middle-low rectal cancer

Abstract

Objective To explore the clinical value of laparoscopic anastomat placement through a lateral incision of the distal rectal segment after anal pull-through resection in order to find a simple and applicable anastomosis method. Methods Clinical data of 60 patients who underwent radical surgery for laparoscopic middle and low rectal cancer at Hezhou People′s Hospital from October 2016 to June 2019 were retrospectively analyzed. According to the surgical method used, the patients were divided into either a control group (30 patients undergoing laparoscopic anterior resection of rectal cancer) or an observation group (30 patients undergoing anal pull-through anastomosis). The t-test was used to compare the differences in operation time, blood loss, number of lymph nodes dissected, time to gastrointestinal function recovery, hospitalization time, and hospitalization cost between the two groups. The chi-square test was used to compare the incidence of postoperative complications between the two groups. Results There were no significant differences in gender, age, body mass index, distance from anal margin, tumor diameter, or tumor invasion depth between the two groups (P>0.05). Operation time, bleeding, number of lymph nodes dissected, time to gastrointestinal function recovery, and hospitalization time also had no significant difference between the two groups (P>0.05). However, the hospitalization cost was significantly lower in the observation group than in the control group [(4.2±1.2) million yuan vs (5.3±2.5) million yuan, t=4.72, P=0.039]. The incidence of postoperative complications in the observation group was lower than that of the control group [3.3% (1/30) vs 6.7% (2/30)], but there was no significant difference between them (P>0.05). Conclusion Anal pull-through resection of tumor and stapler placement through a distal rectal incision is a new, simple, and feasible anastomosis procedure, which can reduce the cost of hospitalization and has a satisfactory effect in the treatment of middle and low rectal cancer. Key words: Laparoscopy; Distal rectal incision; Pull-through; Tumor, resected, anastomosed; Rectal cancer