Laproscopic pelvic approach to ISR for ULAR

Abstract：Objective To investigate the feasibility of pelvic approach directly to intersphincterie resection(ISR)for ultra-lower anterior resection(ULAR) when undergoing laproseopic total mesenteric excision(TME).Methods A total of 47 patients with a rectal cancer at a distance of 4～5cm from anal verge had an ISR from January 2008 to July 2009.Thirty-seven patients were included according to the review standards.Laparoscopic group included 21 patients and open group 16 patients.Results The general information between two groups is comparability.(1)Complications:Four patients in laparoscopic group had the complications such as chylus leak in 2 cases,stoma bleeding in 1 case and adhesive ileus in 1 case.Five patients in open group had such as pulmonary infection in 3 cases,chylus leak in 1 cage and urinary retention in 1 case.(2)Fecal function(Vaizey score):It was(2.4±2.4)(0～9 score)in laparoscopic group and (2.4±2.4)(0～8 score)in open group.There was no significant difference of fecal function in two groups.(3)Prognosis:The case of local metastasis and recurrence in two groups have not been found up to now.Conclusion Laproscopic pelvic approach to ISR for ULAR is feasible and safety.