Analysis of the Clinical Effect of Laparoscopic Total Mesorectal Excision for the Treatment of Middle and Low Rectal Cancer

Ki Chang Keum, Lisa Cooper

Abstract


The purpose of this study was to analyze the clinical efficacy of laparoscopic total mesorectal excision for the treatment of middle and low rectal cancer. First, 30 patients who received treatment in the hospital from March 2013 to May 2018 were randomly selected as the laparotomy group to receive laparotomy. 30 patients who received treatment in the hospital from March 2013 to May 2018 were randomly selected as the laparoscopic group to receive laparoscopic surgery. The postoperative and complications of total rectal mesorectal excision were compared between the two groups. The results showed that the amount of blood loss during laparoscopy was (169.36±106.96) mL, and that during laparoscopy was (180.65±153.22) mL, which was significantly lower than that of the open group (209.65±186.65) mL and (356.54±170.32) mL. Intraoperative blood loss in laparoscopic patients was significantly lower than that in the open group, and the difference was statistically significant (t =2.95, 2.87, P<0.05). The duration of anal sparing surgery in the laparoscope group was (232.65±56.35) min, which was longer than that in the laparoscope group (227.65±68.65) min. The duration of non-sparing anal surgery in the laparoscopic group was (246.95±52.65) min, which was significantly shorter than that in the open group (299.65±64.32) min. There was no statistically significant difference in the duration of operation between the laparoscopic group and the open group. The recovery time of intestinal function in the laparoscopic group was (2.11±1.82) days, which was significantly shorter than that in the open group (4.63±1.52) days. The postoperative hospital stay in the laparoscopic group was (11.32±10.01) d, which was significantly shorter than that in the open group (26.62±12.43 d). The recovery time of intestinal function and postoperative hospital stay of patients in the laparoscopic group were shorter than those in the open group, with statistically significant differences (T =2.31, 2.43, P<0.05). The tumor diameter was (4.03±1.20) cm in the laparoscopic group and (3.95±1.43) cm in the open group. The number of lymph nodes in the laparoscopic group was (12.75±6.51)cm, while that in the open group was (13.62±7.05). There was no significant difference in the number of lymph nodes dissected or tumor diameter between the two groups (t=0.11, 0.22, P>0.05). The complication rate of the abdominal group was 20.00%, significantly lower than that of the open group (66.67%). Complications after total mesorectal resection were significantly higher in the open group than in the laparoscopic group, and the difference between the two groups was statistically significant (χ2=13.30, P<0.05). Therefore, laparoscopic total rectal mesorectal resection for patients with middle and low rectal cancer is safer and can be used as a reliable treatment plan.


Keywords


Laparoscope; Total mesangial rectal resection; Middle and low rectal cancer

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References


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DOI: http://dx.doi.org/10.30564/amor.v5i6.260

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