Application analysis of laparoscopic transanal pull-through resection and anastomosis for middle and low rectal cancer

doi:10.3877/cma.j.issn.1674-0793.2018.06.010

Abstract

Abstract:

Objective

To evaluate the efficacy of transanal pull-through laparoscopic anterior resection in the treatment of middle and low rectal cancer.

Methods

From April 2015 to April 2017, one hundred cases with middle and low rectal cancer admitted to the Hospital of PuRen River in Wuhan were prospectively selected. According to the random number table method, the patients were divided into the control group (treated with laparoscopic anterior resection) and the observation group (treated with transanal pull-through resection and anastomosis), with 50 cases in each group. The perioperative period, levels of inflammatory factors such as tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and follow-up data were compared between the two groups.

Results

(1) The operation time, recovery time of intestinal function, flow rate, hospital stay, costs of the observation group were significantly less than those of the control group, and the differences were statistically significant (P<0.01). (2) There were no significant differences in the levels of TNF-α and IL-6 between the two groups before operation. Compared with preoperation, the levels of TNF-α and IL-6 in the two groups decreased significantly (P<0.05), and the level in the observation group was significantly lower than the control group at the same period (P<0.05). (3) There were no significant differences in the incidence of complications, 1 year recurrence rate and fatality rate between the two groups (χ²=0.154, 0.519, 0.852; all P>0.05).

Conclusion

Transanal pull-through total laparoscopic anterior resection is an ideal treatment for middle and low rectal cancer, which can significantly improve operation related indicators, reduce the inflammatory response to the body, and is of worth carrying out.

Key words: Rectal neoplasms, Colorectal surgery, Gastroenterostomy, Transanal pull-though

Xingfeng Yin, Fan Jiang. Application analysis of laparoscopic transanal pull-through resection and anastomosis for middle and low rectal cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(06): 409-412.

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References 15

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组别	例数	男/女（例）	年龄（岁）^a	病程（年）^a	肿瘤直径（mm）^a	肿瘤与肛缘距离（cm）^a	肿瘤分期（例）
组别	例数	男/女（例）	年龄（岁）^a	病程（年）^a	肿瘤直径（mm）^a	肿瘤与肛缘距离（cm）^a	T1	T2
对照组	50	29/21	58.0±11.2	1.1±0.4	4.5±0.9	5.4±2.1	28	22
观察组	50	28/22	58.3±10.9	1.0±0.4	4.7±0.8	5.5±1.9	29	21
统计值	?	χ²=0.041	t=0.136	t=1.250	t=1.174	t=0.250	χ²=0.041
P值	?	0.840	>0.05	>0.05	>0.05	>0.05	0.840

组别	例数	男/女（例）	年龄（岁）^a	病程（年）^a	肿瘤直径（mm）^a	肿瘤与肛缘距离（cm）^a	肿瘤分期（例）
组别	例数	男/女（例）	年龄（岁）^a	病程（年）^a	肿瘤直径（mm）^a	肿瘤与肛缘距离（cm）^a	T1	T2
对照组	50	29/21	58.0±11.2	1.1±0.4	4.5±0.9	5.4±2.1	28	22
观察组	50	28/22	58.3±10.9	1.0±0.4	4.7±0.8	5.5±1.9	29	21
统计值	?	χ²=0.041	t=0.136	t=1.250	t=1.174	t=0.250	χ²=0.041
P值	?	0.840	>0.05	>0.05	>0.05	>0.05	0.840

组别	例数	手术时间（min）	出血量（ml）	淋巴结清扫数目（枚）	肠功能恢复时间（h）	术后引流量（ml）		住院时间（d）	治疗费用（万元）
组别	例数	手术时间（min）	出血量（ml）	淋巴结清扫数目（枚）	肠功能恢复时间（h）	日均量	总量	住院时间（d）	治疗费用（万元）
对照组	50	149.6±28.4	94.3±30.7	14.8±2.7	72.8±9.0	76.3±20.2	337.3±51.5	15.0±2.9	2.9±0.7
观察组	50	127.5±17.2	98.4±37.3	14.7±2.5	54.9±7.3	48.4±13.6	253.7±38.5	11.6±1.9	2.4±0.5
t值	?	4.707	0.600	0.192	10.922	8.101	9.193	6.934	4.110
P值	?	<0.01	>0.05	>0.05	<0.01	<0.01	<0.01	<0.01	<0.01

组别	例数	手术时间（min）	出血量（ml）	淋巴结清扫数目（枚）	肠功能恢复时间（h）	术后引流量（ml）		住院时间（d）	治疗费用（万元）
组别	例数	手术时间（min）	出血量（ml）	淋巴结清扫数目（枚）	肠功能恢复时间（h）	日均量	总量	住院时间（d）	治疗费用（万元）
对照组	50	149.6±28.4	94.3±30.7	14.8±2.7	72.8±9.0	76.3±20.2	337.3±51.5	15.0±2.9	2.9±0.7
观察组	50	127.5±17.2	98.4±37.3	14.7±2.5	54.9±7.3	48.4±13.6	253.7±38.5	11.6±1.9	2.4±0.5
t值	?	4.707	0.600	0.192	10.922	8.101	9.193	6.934	4.110
P值	?	<0.01	>0.05	>0.05	<0.01	<0.01	<0.01	<0.01	<0.01

组别	例数	TNF-α（μg/L）				IL-6（ng/L）
组别	例数	术前	术后	t值^a	P值^a	术前	术后	t值^a	P值^a
对照组	50	54.2±5.1	41.8±3.9	13.657	<0.01	154.7±41.1	95.2±22.7	8.961	<0.01
观察组	50	54.4±5.0	31.1±2.6	29.235	<0.01	149.0±41.4	51.5±13.2	15.867	<0.05
t值^b	?	0.198	16.142	?	?	0.691	11.768	?	?
P值^b	?	>0.05	<0.01	?	?	>0.05	<0.01	?	?

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