Comparison Of Short-term Efficacy Of Laparoscope-assisted Transanal Total Mesorectal Excision Versus Standard Laparoscopic Surgery For Rectal Cancer

Objective:To compare the short-term efficacy of laparoscopic-assisted total mesorectal excision（taTME）with standard laparoscopic total mesorectal excision（laTME）for low rectal cancer.Method:Retrospective analyze clinical data of 50 consecutive patients from our hospital between March 2018 to October 2019 who underwent taTME surgery.And anothere 50 patients who underwent laTME were compared with the problem.They have no significant difference in gender,age,body mass index（BMI）,tumor location and pathological staging.Observe and compare the two groups of patients in perioperative related situation,the quality of specimens,and the differences between the pathological results.Result:TaTME group have longer operation time than laTME group,taTME group have higher rate of manual anastomosis than laTME group.The incidence of postoperative intestinal obstruction and postoperative urinary retention is lower in taTME group.TaTME group have shorter postoperative initial feeding time than laTME group.Hospitalization costs were lower in the taTME group than in the laTME group（P<0.05）.In the two groups,the intraoperative blood loss,prophylactic ileostomy,transition rate,the rate to keep anus,specimen quality,distal resection margin distance,positive rate of distal resection margin,positive rate of circumferential resection margin,number of harvested lymph nodes,tumor diameter,tumor TNM staging,intraoperative CO₂embolization,urethral injury,rectal perforation,neurovascular bundle hemorrhage,postoperative anastomotic leakage,prostate hemorrhage and stomatal outlet obstruction、postoperative hospital stay and the first time of postoperative out-of-bed activity are comparable（P>0.05）.Conclusion:Laparoscopic assisted transanal total mesorectal resection in the short-term treatment（surgical indicators,specimen quality,perioperative complication rate,postoperative recovery rate,etc）of low rectal cancer is not less effective than standard laparoscopic surgery.And has its own advantages in some aspects（postoperative intestinal obstruction and urinary retention incidence,postoperative first feeding time,hospital expenses,etc）.It is worth further research and extension.