To compare the safety, advantages and disadvantages of Hetao method and purse-string forceps method of insertion of anvil in laparoscopic high anterior rectal resection without auxiliary abdominal incision (CRC-NOSES Ⅳ type).

From January 2019 to September 2022, 103 patients with sigmoid colon cancer or high rectal cancer who underwent laparoscopic high anterior rectal resection (CRC-NOSES Ⅳ type) were selected as the study subjects. According to the different insertion methods of the anvil, 63 cases were divided into the Hetao group and 40 cases into the purse-string forceps group. The operation time, placement time, intraoperative blood loss, postoperative recovery and complications were compared between the two groups.

The placement time of anvil in the purse-string forceps group was (8.9±2.2) min, which was significantly shorter than (13.9±2.3) min in the Hetao group (t=10.908, P<0.001). There were no significant differences between the two groups in terms of operation time, intraoperative blood loss, bed-off time after operation, time of exhaust after operation, or time of hospitalization after operation. The incidence of anastomotic leakage, intestinal obstruction, anastomotic bleeding, abdominal bleeding, intra-abdominal infection and total complications in the two groups were not statistically significant.

Hetao method and purse-string forceps method have their own advantages and disadvantages, both of which are safe and reliable in laparoscopic high anterior rectal resection of CRC-NOSESⅣtype, with similar surgical complications and postoperative recovery. The two methods are worth trying and promoting.