Abstract:
Objective To analyze the safety and long-term prognosis of two kinds of laparoscopic surgery for elderly patients with low rectal cancer.
Methods The clinical data of 100 patients with low rectal cancer from January 2013 to January 2016 were retrospectively analyzed. According to different surgical methods，50 patients treated with laparoscopic intersphincteric resection（ISR）were included in the ISR group. A total of 50 patients treated with laparoscopic perineal resection of rectal cancer（Miles surgery）were included in the Miles group. SPSS 23.0 software was used for processing. Surgery-related indicators，Wexner score for anal incontinence，and quality of life（GQOLI-74）score were expressed as（
±s），and independent
t test was performed. The incidence of complications and tumor recurrence rate were expressed as percentage，and
χ2 test was performed. The survival rate was tested by
Log-Rank method.
P<0.05 was considered statistically significant.
Results The operation time and intraoperative blood loss in ISR group were shorter than those in Miles group（P<0.05）. There were no significant differences in the number of lymph nodes dissected，distance between distal resection margin and lower tumor margin，length of hospital stay，incidence of complications，3-year and 5-year survival rates，and tumor recurrence rate between the two groups（P>0.05）. At 3 and 6 months after operation，the Wexner score of ISR group was lower than that of Miles group（P<0.05）. At 1 year after surgery，the scores of physical function，social function and psychological function of patients in ISR group were higher than those in Miles group（P<0.05）.
Conclusion Laparoscopic ISR in the treatment of elderly low rectal cancer has similar medium and long-term prognosis as Miles surgery，but ISR is less invasive，can preserve the anal function of patients，improve postoperative quality of life，and avoid enterostomy complications.
Key words:
Rectal neoplasms,
Laparoscopes,
Intersphincteric resection,
Anal function,
Comparative effectiveness research
Xuewen Yang, shushang Liu, Gaozan Zheng, Feng Gao, Mengbin Li. Comparison of safety and long-term follow-up of two kinds of laparoscopic surgery for elderly patients with low rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(06): 680-683.