Comparison of single-port and multiple-port laparoscopic assisted transanal total mesorectal excision in the treatment of low rectal cancer

Abstract

Objective To compare the effects of single-port and multiple-port laparoscopic assisted transanal total mesorectal excision (TaTME) on the anorectal dynamics and inflammatory factors in the treatment of low rectal cancer. Methods A retrospective analysis of eighty-four patients with low rectal cancer admitted to the People's Hospital of Longhua District from April 2015 to July 2017 was carried out and they were divided into single-port group (40 cases, treated with single-port laparoscopic TaTME) and multiple-port group (44 cases, treated traditional porous laparoscope-assisted TaTME). The perioperative indexes, preoperative anorectal dynamic indexes and levels of serum inflammatory factors between the two groups were observed and compared. Results (1) The perioperative indexes of intraoperative bleeding, operation time, number of lymph node dissection, postoperative anus exhaust time, removal of drainage tube time, bed activity time and total hospitalization time of the single-port group were significantly better than those of the multiple-port group (all P<0.05). (2) Compared with preoperative levels, the ARP, MSP, MTV and HPZ decreased significantly at 15 d after operation, and the levels of RRP and AIRT increased significantly, the differences were statistically significant between the two groups (P<0.05). The levels of ARP, MSP, MTV and HPZ in the multiple-port group at 15 d after operation were significantly lower than those in the single-port group (P<0.05), while RRP and AIRT levels were significantly higher (P<0.05). (3) There were no significant differences in serum inflammatory factors such as IL-6, IL-8, SAA, TNF-α and CRP between the two groups before operation. After operation, the levels of serum inflammatory factors in the two groups were both significantly increased (P<0.05), of which the multiple-port group was significantly higher than that in the single-port group (P<0.05). Conclusion Compared with conventional multiple-port laparoscopy, single-port laparoscopic assisted TaTME can obviously improve surgical treatment for low rectal cancer, while the influences on anorectal motility and inflammatory factor levels are smaller, and is worthy of further promotion. Key words: Rectal neoplasms; Colorectal surgery; Laparoscopes; Anorectal dynamics; Inflammatory factors