Short term efficacy of total mesorectal excision laparoscopic surgery combined with neoadjuvant therapy treating low rectal cancer

Huang Jihua; Liang Weicheng; Li Huajiang; Cai Ruiwen; Liang Huayan; Huang Kaijin; Liang Dunbo

doi:10.3760/cma.j.issn.1673-4777.2015.01.007

Abstract：Objective To explore the short term efficacy of total mesorectal excision (TME) laparoscopic surgery combined with neoadjuvant therapy for the treatment of low rectal cancer.Methods Totally 84 patients with low rectal cancer were randomly and equally divided into observation group and control group.All patients underwent neoadjuvant therapy; the surgery was performed 6-8 weeks after chemotherapy.The observation group underwent TME laparoscopic surgery and the control group underwent open colectomy.The recovery and surgical removal of the tumor markers were compared.Results Exhaust time in the observation group was significantly lower than in the control group[(40 ±13)h vs (61 ± 15)h)] ; liquid diet recovery time was significantly shorter than that in the control group [(50 ± 14)h vs (67 ± 13)h] ; postoperative recovery of normal diet was significantly shorter than that in the control group [(85 ± 10)h vs (95 ± 13)h)] ; defecation was significantly lower than that in the control group[(94 ± 16)h vs (119 ± 17)h] ; the length of hospital stay was significantly shorter than that in the control group (median time:10 d vs.13 d) ; the incidence of lung infection was significantly lower than that in the control group[2.4％ (1/42) vs 14.3％ (6/42)] (all P ＜ 0.05).The oncology-related indicators of surgical resection including tumor size,number of lymph nodes,tumor differentiation,ypT type,proximal resection,resection of the distal radial extent,circumferential resection margin status and TME complete resection specimens showed no statistical difference between the two groups (P ＞ 0.05).Conclusions TME laparoscopic surgery and open surgery in the treatment of low rectal cancer is effective.TME laparoscopic surgery is feasible with a short postoperative exhaust time,diet recovery time,postoperative defecation and length of hospitalization.