The feasibility analysis of tranasnal minimally invasive surgical treatment for rectal cancer

Abstract

Objective To evaluate the clinical curative effect of the transanal minimally invasive surgery (TAMIS), is aiming to provide a better surgical procedure for patients. Methods Retrospective analysis of 52 cases of patients with colorectal neoplasm local resection from July 2012 to September 2014 in the department of colorectal surgery of the Second Affiliated Hospital of Harbin Medical University. 30 cases were TAMIS group, 22 cases were TAE group. All the patients were followed up, and recorded detail clinical data. Results In TAMIS group, the average operation time was 41.5 minutes (25~90), the average length of hospital stay was 3 days (1~4), and setup time of SILS Port was 3 minutes on average (1~5). The average operation time of TAE group was 55 minutes (25~110), and the average length of hospital stay was 3 days (1~4). 52 cases were obtained complete resection, with no positive cut edge. Of all the patients, 1 case was with anal sphincter dysfunction, 1 case was with urinary retention shortly after the postoperation, 1 case was with postoperative anal bleeding. The difference of distance from neoplasm to anal edge was of statistical significance in two groups of patients, TAMIS technique can get wider operation range, and TAMIS group has shorter operation time (41.5 minutes, P<0.05); In terms of anal function, the score of fecal incontinence in TAMIS group was significantly decreased (P=0.002), anal function recovered well; The intensity score of postoperative pain was lower than TAE group (P=0.001), TAMIS curve formula was Y=-13.15 ln (x)+ 79.563 after mathematical analysis. According to operation time, the 12th case was inflection point in the second derivative curve, indicating the previous 12 cases were the learning phase. Conclusions Transanal minimally invasive surgery can be finished by conventional laparoscopic instruments, the learning curve is smooth, and easy to master, with smaller anus function damage, mild postoperative pain, wide scope of operation and clear operation field, which was of good curative effect in the treatment of benign neoplasm or local excision of early rectal cancer. Key words: Anal canal; Rectal neoplasms; Surgical procedures, minimally invasive