To compare the clinical effects of conventional laparoscopy (CL) and laparoscopy with natural cavity specimen removal (NOSES) in the treatment of middle and high rectal cancer.

The clinical data of 100 patients with middle-high rectal cancer from July 2017 to July 2019 in two hospitals were divided into CL group (58 cases received CL operation) and Noses group (42 cases received Noses) according to different surgical plans. SPSS 23.0 software was used for data analysis. Perioperative related indexes and recovery indexes were expressed as (±s), independent t test. χ² test was used for complications and anal function, and P<0.05 was considered statistically significant.

The visual analogue scale (VAS) score of NOSES group was lower than that of CL group at 48 h after operation (P<0.05), and the time of first getting out of bed, anal exhaust time and postoperative hospitalization were shorter than that of CL group (P<0.05); There was no significant difference in the total good rate of anal function(88.10%) and the incidence of postoperative complications (7.1%) in NOSES group compared with CL group (93.10%, 12.1%) at 3 months after operation were not significantly different (P>0.05); Pap index (BI) score was higher in NOSES group than in CL group at 3 months after operation (P<0.05); there was no significant difference in PFDI-20 score between the two groups at 3 months after operation (P>0.05).

there was no significant effect on anal function and pelvic floor function after operation in patients with middle and high rectal cancer. There were fewer complications after operation, but NOSES was less invasive, less pain and shorter hospital stay, and is conducive to improving patient life self-care ability.