Comparison of the efficacy and safety of two TME methods in the treatment of ultra low rectal cancer

Abstract

Objective To investigate the efficacy and safety of two kinds of total mesorectal excision in patients with ultra-low rectal cancer. Methods From June 2013 to January 2016, 84 patients with ultra-low rectal cancer treated in our hospital were retrospectively analyzed. The patients were divided into the laparoscopic TME group and the transanal total mesorectal excision (TaTME) group, each with 42 cases. After treatment, the two groups of patients were followed up for 1 year. The SPSS20.0 was used to analysis the data, perioperative index, PAC-QOL score were showed as (±s) and compared with independent t test; the incidence of complications, mortality, recurrence rate, metastasis rate were compared with χ2 test. P<0.05 meant the difference was statistically significant. Results There was no significant difference in the postoperative analgesia time, indwelling catheter time and the number of lymph node between two group (P>0.05). The operation time of group TaTME was longer than that of laparoscopic TME group, the amount of bleeding, hospitalization time, anal exhaust time was lower than that of laparoscopic TME group, the difference was statistically significant (P 0.05); The TaTME group had PAC-QOL (36.8±3.0), which was lower than the laparoscopic group (40.4±3.7), the difference was statistically significant (P 0.05), there was no significant difference in local recurrence and distant metastasis between the two groups (P>0.05). Conclusion Compared with laparoscopic total mesorectal excision, transanal total mesorectal excision has advantages in improving the quality of life, shortening the length of stay, and reducing the amount of bleeding during operation. There is no significant differences in incidence rate of complications, recurrence, metastasis and death. Key words: Rectal Neoplasms; Mesentery; Surgical Procedures, Operative; Comparative Study