To investigate the clinical efficacy and safety of laparoscopic and open TME for ultra low rectal cancer.

From January 2013 to December 2015, 110 patients with ultra low rectal cancer who treated in our hospital were enrolled into this study, who were divided randomly into laparotomy group (55 cases) and laparoscopic group (55 cases). Clinical data were analyzed by using statistical software SPSS 21.0. Measurement data such as perioperative indicators and Wexner score were expressed as mean±standard deviation, and independent t test was used for comparison between the groups. Count data, such as membrane integrity rate, postoperative complication rate and survival, were expressed as %, and were examined by using χ² test or Fisher exact test. A P value <0.05 was considered as statistically significant difference.

The distal margins and harvested lymph nodes were similar in both groups (P>0.05). The operation time, abdominal incision length and intraoperative blood loss in laparoscopic group were less than those in laparotomy group respectively, and the mesangial integrity rate in the laparoscopic group was higher than that in the laparotomy group, with significant difference (P<0.05). Postoperative anal exhaust time, food intake time, postoperative ambulation time and hospital stay in the laparoscopic group were shorter than those in the laparotomy group respectively, while postoperative analgesia demand rate was lower in the laparoscopic group (P<0.05). The incidence of defecation difficulty and urgency and anal satisfaction were similar between two groups. The frequency of defecation and Wexner score were similar. There was no significant difference of 2 year survival rate between two groups (P>0.05). The incidence of complications in the laparoscopy group was 5.5% and 18.2% in the laparotomy group, There were significant difference of complication rate between two groups (χ²=4.274, P=0.039).

Patients underwent laparoscopic TME for ultra-low rectal cancer could undergo less trauma, faster postoperative recovery, less complications, with the same curative effect and ong-term efficacy as open surgery, It is recommended that patients could selectively choose laparoscopic TME for the treatment of low rectal cancer.