Clinical Application Of Minimally Invasive Surgery In Rectal Tumors

Background:With the change of people’s diet with high salt and fat,the incidence rate of colorectal cancer is increasing year by year.According to statistical data released by China’s Cancer Center,there were 408000 new cases of colorectal cancer in China in 2016,ranking second only to new cases of lung cancer;colorectal cancer has 196000 deaths,ranking fifth.Therefore,the treatment of colorectal cancer is of great significance.The innovation of medical technology and the transformation of concepts have led to the acceptance of local excision surgery for the treatment of benign rectal tumors and early rectal cancer by many mathematicians.One of the minimally invasive surgical methods for local resection is Transanal minimally invasive surgery(TAMIS),which involves inserting a single laparoscopic channel into the anal canal and using ordinary laparoscopic instruments to achieve local tumor resection without the need for expensive equipment.Surgeons with laparoscopic technology can perform this surgery.Transanal minimally invasive surgery(TAMIS)has a clear field of vision,which can better expose the tumor cutting edge,achieve complete tumor resection,and avoid residual tumor and postoperative recurrence;At the same time,it inherits the magnifying effect of laparoscopy,making intraoperative hemostasis and suturing more precise,significantly reducing the occurrence of intraoperative bleeding and postoperative intestinal stenosis;Due to its unique advantages,it has become easy to handle tumors in the middle and lower segments of the rectum and has good development potential.To further explore the feasibility and safety of this surgical procedure,we compared it with traditional transanal resection(TAE).Objective:Explore the safety and effectiveness of Transanal minimally invasive surgery for rectal tumors.Methods:A retrospective analysis was conducted on the clinical data of rectal tumor patients who underwent local resection surgery at Nanyang Central Hospital from September 1,2020 to December 31,2021(n=59).They were divided into TAMIS group(n=32)and TAE group(n=27)based on different surgical methods chosen by the patients.Compare the surgical time,intraoperative bleeding volume,severity score of fecal incontinence at 6 months after surgery,first day pain intensity digital scoring method score,average hospital stay,incidence of postoperative complications,and 1-year recurrence rate between the two groups of patients.Results:There was no statistically significant difference(P>0.05)in the negative rate of surgical margin,incidence of postoperative complications,and recurrence rate between the two groups of patients.Compared with the TAE group,the TAMIS group had shorter surgical time(t=2.47,P=0.017),less intraoperative bleeding(t=4.46,P<0.001),lower anal pain score on the first day after surgery(t=7.76,P<0.001),shorter average hospital stay(t=4.75,P<0.001),and a more dominant fecal incontinence severity score at 6 months after surgery(t=3.22,P=0.002)Conclusion:1.Transanal minimally invasive surgery has the advantages of minimal surgical trauma,minimal bleeding,fast recovery,precise therapeutic effect,and the ability to preserve anal function to the greatest extent possible.2.Transanal minimally invasive surgery is a safe and effective surgical method for treating benign tumors and early cancer of the middle and lower rectum.